Hall Brian J, Florell Scott R, Sklow Bradford, Liu Ting
Department of Pathology, University of Utah Hospitals, Salt Lake City, UT 84112, USA.
Am J Dermatopathol. 2012 Jun;34(4):438-41. doi: 10.1097/DAD.0b013e31822e6895.
Apocrine carcinoma (AC) is an extremely rare skin appendage tumor, which is located at lower dermal and subcutaneous tissue. We report a case of an anal AC arising from an apocrine adenoma in the anal region, which is only the second case reported in this region. A 71-year-old male presented to clinic with soreness in the anal region for 6 weeks. An excisional biopsy was performed. Histologically, the lesion was poorly circumscribed, infiltrative, and was composed of small to medium sized glands extending to the surgical margins. There were centrally dilated large glands with duct-like openings into the mucosal surface. The larger central glands contain periodic acid-Schiff-positive eosinophilic acellular secretions. At the periphery, there were smaller glands with significant cytologic atypia and numerous mitoses. A diagnosis of AC was made making it the second case report of this very rare malignancy in this region. Although ACs usually do not have a fatal outcome, there have been case reports of distant metastases and even death from this disease, making histologic distinction of this malignancy from a benign apocrine adenoma important. Wide local excision is typically the treatment of choice, although Mohs micrographic surgery has also been used with similar success.
大汗腺癌（AC）是一种极其罕见的皮肤附属器肿瘤，位于真皮深层和皮下组织。我们报告一例起源于肛门区域大汗腺腺瘤的肛门AC病例，这是该区域报道的第二例。一名71岁男性因肛门区域疼痛6周就诊。进行了切除活检。组织学上，病变边界不清，呈浸润性，由小至中等大小的腺体组成，延伸至手术切缘。中央有扩张的大腺体，有导管样开口通向黏膜表面。较大的中央腺体含有过碘酸希夫染色阳性的嗜酸性无细胞分泌物。在周边，有较小的腺体，具有明显的细胞异型性和大量有丝分裂象。诊断为AC，这是该区域这种非常罕见恶性肿瘤的第二例报告。尽管大汗腺癌通常不会导致致命后果，但已有远处转移甚至死于该病的病例报告，因此将这种恶性肿瘤与良性大汗腺腺瘤进行组织学鉴别很重要。广泛局部切除通常是首选治疗方法，尽管莫氏显微外科手术也已成功应用。
