Two Different Cell Populations Is an Important Clue for Diagnosis of Primary Cutaneous Adenoid Cystic Carcinoma: Immunohistochemical Study

Abstract

Primary cutaneous adenoid cystic carcinoma (PCACC) is a very rare malignancy. The differential diagnosis of PCACCs in pathology practice can be difficult and a group of primary and metastatic lesions, including adenoid basal cell carcinoma of the skin, should be considered in the differential diagnosis. Besides histomorphological clues, immunohistochemistry studies are very helpful in the differential diagnosis of PCACC. We report herein a case of PCACC with extensive immunohistochemical studies and review the literature from an immunohistochemistry perspective.

Primary cutaneous adenoid cystic carcinoma on the lower leg

“…Immunohistochemically, Alkan BI et al reported in his case study that PCACC showed BerEp4, CEA, CD117(C-kit), and CK7 expression in the regions neighboring the luminal areas, and p63 and SMA positivity were detected in myoepithelial cells at the periphery of the cell islands. He said the two different cell populations provided an important clue for diagnosis because the tumor cells showed ductal and myoepithelial differentiation [5]. In fact, these features helped us for diagnosis in this case.…”

Eccrine spiradenoma mimicking adenoid cystic carcinoma cytologically (Two case reports and literature review)

“…10 Histologically the tumor cells show epithelial and myoepithelial differentiation. 11 Morphologically PACC is indistinguishable from ACC of other sides and metastasis should be excluded clinically. 10 Compared to its salivary gland synonym, PCACC has an indolent course, but local recurrences and rare nodal or metastatic spread may occur.…”

“…2,13 Similarly, it has been shown that epithelial cells in ACC are stained with PanCK, CD117, CK7, and myoepithelial cells with p63 and calponin. 9,11,14 However, there are publications considering that β-catenin staining pattern can work in discrimination. Im et al detected nuclear β-catenin staining in 70% of ES cases.…”

Tumor with slow‑developing and recurring lumps of the external ear with skull base and lung metastasis: A case report

“…Immunohistochemistry is useful for the diagnosis of ACC ( 16 , 18 ). ACC is characterized by slow progression but has a high propensity to invade and metastasize, particularly via perineural invasion, which occurs in ≤70% of ACC cases ( 19 ). ACC involving the skull base (orbital contents/bone, sinonasal cavities, nasopharynx, cavernous sinus, clivus, pterygopalatine fossa and infratemporal fossa) is usually identified via novel imaging techniques ( 20 ).…”