Primary Cutaneous Apocrine Carcinoma: Diagnostic and Management Difficulties of an Uncommon Neoplasm

Mounia Sidki, M. Aboudourib, Maryam El Ouazzani, A. Belbachir, H. Rais, Yassine Benchamkha, O. Hocar, S. Amal
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Abstract

Primary cutaneous apocrine carcinoma (PCAC) is a rare adnexal neoplasm. Due to its clinical presentation, it can mimic other tumors, especially metastasis. We present a case of primary apocrine carcinoma of the axilla mimicking breast carcinoma metastasis in a 54-year-old woman. The patient presented with a painless, lobed, and erythematous nodule in the left axilla of one year duration. We suspected an adnexal neoplasm but also considered metastasis from breast carcinoma. Histological examination revealed apocrine proliferation. Immunohistochemistry stains of tumor cells were positive for AE1/AE3, and negative for CK7, CK20, p63 and GATA3. Radiological explorations did not reveal any signs of malignancy. Considering all these features, the conclusive diagnosis was primary cutaneous apocrine carcinoma. Treatment was wide excision without adjuvant therapy, and no recurrence was noted. Due to the rarity of this carcinoma, its various clinical presentations, and histological overlaps with breast cancer metastasis, making the diagnosis may be challenging. A comprehensive evaluation of all findings is necessary to rule out other tumors. There is any consensus on the management strategy. The standard treatment is surgical excision, but adjuvant therapies such as radiotherapy or chemotherapy can be proposed in advanced stage disease.
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原发性皮肤腺分泌癌:一种不常见肿瘤的诊断和管理难题
原发性皮肤腺癌(PCAC)是一种罕见的附件肿瘤。由于其临床表现,它可以模仿其他肿瘤,尤其是转移瘤。我们介绍了一例腋窝原发性腺分泌癌,患者为 54 岁女性,模仿乳腺癌转移。患者左侧腋窝无痛、分叶、红斑结节,病程一年。我们怀疑是附件肿瘤,但也考虑是乳腺癌转移。组织学检查显示该肿瘤为腺体增生。肿瘤细胞的免疫组化染色显示 AE1/AE3 阳性,CK7、CK20、p63 和 GATA3 阴性。放射学检查未发现任何恶性肿瘤迹象。考虑到所有这些特征,最终诊断为原发性皮肤腺分泌癌。治疗方法是大范围切除,没有辅助治疗,也没有发现复发。由于这种癌症非常罕见,临床表现多种多样,而且在组织学上与乳腺癌转移重叠,因此诊断可能具有挑战性。有必要对所有检查结果进行综合评估,以排除其他肿瘤。关于治疗策略,目前尚无共识。标准的治疗方法是手术切除,但对于晚期患者,可采用放疗或化疗等辅助疗法。
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