Microcystic Adnexal Carcinoma: Report of 13 Cases and Review of the Literature

Snow, Stephen N.; Madjar, David; Hardy, Stephen P.; Bentz, Michael L.; Lucarelli, Mark J.; Bechard, Robert; Aughenbaugh, William; McFadden, T.B.; Sharata, Harry H.; Dudley, Catherine; Landeck, Anya

doi:10.1046/j.1524-4725.2001.00208.x

Cited by 99 publications

(132 citation statements)

References 56 publications

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“…These tumors are able to develop gradually for a number of months or years in a locally aggressive mode. MACs have a 50% postoperative local recurrence rate, with very rare instances of metastasis (1,2,11). The macroscopic characteristics of the MAC case reported in the present study were similar to those reported in previous literature (2,3,7,9,10).…”

Section: Discussionsupporting

confidence: 88%

“…Chiller et al (18) observed that the size of the affected surface area after full excision with MMS was four times larger compared with the clinically apparent size. Therefore, this method ensures complete excision of the cancerous tissue, and subsequently the recurrence rates following MMS are low (0-12%) (11). In the present study, the patient was treated with MMS following reconstruction, and no tumor recurrence was detected during the three-year follow-up period.…”

Section: Discussionmentioning

confidence: 62%

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Treatment of nasal microcystic adnexal carcinoma with an expanded rotational forehead skin flap: A case report and review of the literature

Zhou

Zhao

Zhang

et al. 2015

Experimental and Therapeutic Medicine

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Abstract. Microcystic adnexal carcinoma (MAC) is a rare and locally aggressive adenocarcinoma with low-grade malignancy. The present study describes the first reported case and treatment of a Chinese male with a MAC located on the nasal dorsum and nosewing. A 44-year-old man presented with a nasal deformity caused by local repeated infections following an accidental injury to the nose 20 years previously. The nose had been injured by a brick, and treatment at a local hospital 12 years previously had resulted in a nasal scar and a gradually enlarging mass. A physical examination revealed a hypertrophic deformity of the nose and an indurated scar plaque, measuring 2.0x2.0 cm, on the nasal dorsum and nosewing. Microscopic examination revealed a tumor consisting of solid cell nests and a cystic structure with a capsular space. In addition, ductal cells of an adnexal cell origin were visible in the outer epithelium. The medial portion exhibited a microductal structure and invasion of deeper tissues without evident atypia. The tumor cells presented normal nuclear to cytoplasmic ratios and minimal mitotic activity. Pathological examination verified that the tumor was a MAC of low-grade malignancy. A complete surgical resection was performed via Mohs micrographic surgery (MMS), and reconstruction was achieved using an expanded rotational forehead skin flap. No tumor recurrence was detected after a three-year follow-up period. Therefore, for effective treatment of similar MAC cases, complete surgical resection using MMS is recommended, and successful reconstruction may be achieved using an expanded skin flap.

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Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 62%

Treatment of nasal microcystic adnexal carcinoma with an expanded rotational forehead skin flap: A case report and review of the literature

Zhou

Zhao

Zhang

et al. 2015

Experimental and Therapeutic Medicine

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“…[85][86][87][88] Clinically, MAC overlaps with BCC as a light-tan, smooth, firm lesion primarily affecting the central face, head, and neck of adult patients of all ages. [85][86][87]89 Histologically, MAC is an ill-defined, infiltrative lesion that extends deep in the dermis (Figure 6). 85,86,89 Deceptively bland squamoid and basaloid cells form tubular and ductal structures that are haphazardly distributed in a desmoplastic stroma (Figure 6, B).…”

Section: Microcystic Adnexal Carcinomamentioning

confidence: 99%

“…85,86,89 Horn cysts, primarily in the superficial portion of the lesion, and eosinophilic secretions within the ductal lumens are frequently identified. 86,87 Mitotic activity is rare to absent. Perineural invasion is common and often a helpful diagnostic finding.…”

Section: Microcystic Adnexal Carcinomamentioning

confidence: 99%

Histologic Mimics of Basal Cell Carcinoma

Stanoszek

Wang

Harms

2017

Archives of Pathology &Amp; Laboratory Medicine

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Context.— Basal cell carcinoma (BCC) is the most common human malignant neoplasm and is a frequently encountered diagnosis in dermatopathology. Although BCC may be locally destructive, it rarely metastasizes. Many diagnostic entities display morphologic and immunophenotypic overlap with BCC, including nonneoplastic processes, such as follicular induction over dermatofibroma; benign follicular tumors, such as trichoblastoma, trichoepithelioma, or basaloid follicular hamartoma; and malignant tumors, such as sebaceous carcinoma or Merkel cell carcinoma. Thus, misdiagnosis has significant potential to result in overtreatment or undertreatment. Objective.— To review key features distinguishing BCC from histologic mimics, including current evidence regarding immunohistochemical markers useful for that distinction. Data Sources.— Review of pertinent literature on BCC immunohistochemistry and differential diagnosis. Conclusions.— In most cases, BCC can be reliably diagnosed by histopathologic features. Immunohistochemistry may provide useful ancillary data in certain cases. Awareness of potential mimics is critical to avoid misdiagnosis and resulting inappropriate management.

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“…Local recurrence rates are approximately 50%. [210][211][212][213][214] Occasionally, the lesion will appear in unusual locations and settings, such a recent case arising in the external auditory canal 15 years after radiotherapy of a nasopharyngeal carcinoma that had occurred in a 12-year boy. 215 Another patient showed the synchronous development of a microcystic adnexal carcinoma with a gastric carcinoma.…”

Section: Introductionmentioning

confidence: 99%

Malignant adnexal neoplasms

2006

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Malignant cutaneous adnexal neoplasms are one of the most challenging areas of dermatopathology. Tumors of the pilosebaceous apparatus can occur as single-lineage neoplasms or may manifest as complex proliferations with multilineal differentiation patterns including not only the germinative component of the hair bulb, the inner or outer root sheath epithelium and the sebaceous gland and duct, but also the sweat duct components that relate to the apocrine secretory apparatus which empties into the follicle near the follicular bulge. Eccrine and apocrine neoplasms present a bewildering array of morphologies, which often defy precise classification. The purpose of this review is to discuss in detail the malignant neoplasms of the cutaneous adnexae and their benign and prognostically indeterminate mimics. Modern Pathology (2006) 19, S93-S126. doi:10.1038/modpathol.3800511Keywords: eccrine carcinoma; sebaceous neoplasia Malignant tumors of the pilosebaceous apparatus, their mimics and precursors IntroductionTumors of the pilosebaceous unit can occur in isolation or in combination with complex proliferations showing multilineal differentiation patterns encompassing those of sweat ducts, epidermis and stroma with its varied components. In this review, we will focus upon the malignant adnexal proliferations, considering benign entities mainly insofar as they impact the diagnostic approach to adnexal carcinoma. We will first turn to the malignant sebaceous neoplasms, their precursors and their mimics. Sebaceous adenoma Clinical FeaturesThe sebaceous adenoma is a benign neoplasm that manifests clinically as a pale yellow nodular lesion, typically of the face, that expresses itself clinically after the age of 50. Tumors range in size from o1 to 45 cm. [1][2][3][4][5][6] These lesions are associated with the Muir-Torre syndrome, comprising the coexpression of cutaneous neoplasms, including those of sebaceous type with well-differentiated squamous epithelial neoplasms, and visceral malignancies, including carcinomas of the breast, ovary, gastrointestinal tract and larynx. [7][8][9][10][11][12][13][14] An occasional patient may manifest a malignant lymphoma of nodal or extranodal type. 10,12,14 Sebaceous neoplasms in the setting of Muir-Torre syndrome are often difficult to classify, showing overlap features between all of the prototypic forms of sebaceous neoplasm ranging from hyperplasia to carcinoma. 13 HistologyThe prototypic sebaceous adenoma manifests 1-2 layers of germinitive cells which mature to form central sebocytes, and have an architecture comprising a sharply circumscribed sebaceous lobule surrounded by a compressed pseudocapsule of dermal stroma ( Figure 1a). The overlying epidermis may be attenuated, but sometimes forms a collarette around the peripheral aspect of the neoplasm. Unlike sebaceous hyperplasia, occasional mitoses may be seen in the lobules of a sebaceous adenoma and in concert with this nucleoli may be somewhat prominent, but the pleomorphism, hyperchromasia and individual cell necrosis of the se...

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Microcystic Adnexal Carcinoma: Report of 13 Cases and Review of the Literature

Cited by 99 publications

References 56 publications

Treatment of nasal microcystic adnexal carcinoma with an expanded rotational forehead skin flap: A case report and review of the literature

Treatment of nasal microcystic adnexal carcinoma with an expanded rotational forehead skin flap: A case report and review of the literature

Histologic Mimics of Basal Cell Carcinoma

Malignant adnexal neoplasms

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