Primary cutaneous adenoid cystic carcinoma

Abstract

A patient had primary cutaneous adenoid cystic carcinoma. The tumor closely resembled adenoid cystic carcinoma of salivary gland origin and was composed of cribriform and tubular masses of basaloid cells. Lumina formed by neoplastic cells contained mucin and hyalin , and similar constituents were located between neoplastic cell masses and adjacent dermis. Perineural invasion was observed. A review of seven other primary cutaneous adenoid cystic carcinomas indicates that this neoplasm tends to affect middle-aged and older individuals, is often present for several years prior to diagnosis, has a propensity for local recurrence, but has not produced metastases in regional lymph nodes or distant sites. Therapy should employ wide surgical excision that extends well beyond the clinical confines of the neoplasm.

Cutaneous Adenoid Cystic Carcinoma with Perineural Invasion Treated by Mohs Micrographic Surgery—A Case Report with Literature Review

“…Microscopic findings of cutaneous ACC are characterized by basaloid cells in the mid to deep dermis, arranged in cords and islands forming tubular structures and cribriform patterns, usually with a lack of connection to the overlying epidermis or adnexal structures [6, 7]. There may be small cystic spaces containing mucinous material that stains positively for hyaluronic acid.…”

“…The lumina of the tubular structures and the surrounding stroma may contain mucin or eosinophilic necrotic cells. True lumina are surrounded by prominent basement membrane material, which is PAS positive, diastase-resistant [6, 7]. Perineural invasion is often seen [6, 7].…”

“…The standard treatment for cutaneous ACC is wide local excision with tumor-free margins established by permanent sections [3, 7]. Adjuvant therapy with local radiation is utilized by some authors [17], although no studies have demonstrated that radiation decreases the risk of local recurrence.…”

Fine Needle Aspiration Cytology of Eccrine Skin Adnexal Tumors

“…Cutaneous adenoid cystic carcinoma: is characterized by epithelial cells and an acellular basement membrane material [21]. The epithelial cells are arranged in cohesive, often spherical or tridimensional globoid clusters of various sizes.…”

Malignant adnexal neoplasms

“…Globules and cylinders of brightly eosinophilic basement membrane-like material, similar to those described in the cutaneous cylindroma, complete the picture. [172][173][174][175][176][177][178] Mitoses are typically inconspicuous and, as mentioned above, the nuclear morphology is often deceptively bland. An important criterion in adenoid cystic carcinoma in any anatomical location is the striking propensity of these tumors to manifest perineural infiltration.…”