Section of Anatomic Pathology, Department of Health Sciences, University of Florence, Florence, Italy.
Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.
Australas J Dermatol. 2020 May;61(2):e189-e195. doi: 10.1111/ajd.13199. Epub 2019 Nov 17.
BACKGROUND/OBJECTIVES: Primary cutaneous apocrine carcinoma is a rare malignant adnexal skin tumour that can recur locally, spread to regional lymph nodes and metastatize to visceral organs. Wide dissemination and death from disease are much less common. The axilla is the most common site of presentation. It is infrequently reported in the head and neck region.
All cases diagnosed as primary cutaneous apocrine carcinoma of the head and neck were retrospectively collected from the archives of the Division of Pathological Anatomy, University of Florence from 1996 to 2016. There was no history or clinical evidence of breast cancer. Clinical data and follow-up were collected by the clinicians.
Nine cases were found, with a mean age of 76 years, ranging in size between 0.3 and 3.5 cm. Clinically, they were frequently mistaken for basal cell carcinomas. Histopathologically, all the tumours showed decapitation secretion, a tubular, solid or mixed (tubulo-papillary and solid-tubular) growth pattern and were predominantly classified as grade 2 tumours. GCDFP-15 and hormone receptors were variably expressed. HER2 and podoplanin were negative in all cases. In one case, spreading to regional lymph nodes was observed. No cases were associated with death due to the disease.
As immunohistochemical analysis lacks specificity in distinguishing primary cutaneous apocrine carcinoma from a cutaneous metastasis of breast carcinoma, detailed clinical history, breast examination, adequate treatment and follow-up are necessary to confirm a diagnosis of primary cutaneous apocrine carcinoma.
背景/目的：原发性皮肤大汗腺癌是一种罕见的恶性附属器皮肤肿瘤，可局部复发、扩散至区域淋巴结并转移至内脏器官。广泛扩散和死于疾病的情况要少见得多。腋窝是最常见的发病部位。它在头颈部的报道较少。
本研究从 1996 年至 2016 年，回顾性地从佛罗伦萨大学病理解剖学系的档案中收集了所有被诊断为头颈部原发性皮肤大汗腺癌的病例。这些患者均无乳腺癌病史或临床证据。临床数据和随访由临床医生收集。
共发现 9 例患者，平均年龄为 76 岁，肿瘤大小在 0.3 至 3.5cm 之间。临床上，这些肿瘤常被误诊为基底细胞癌。组织病理学上，所有肿瘤均显示断头分泌，管状、实性或混合（管状-乳头状和实性-管状）生长模式，主要分为 2 级肿瘤。GCDFP-15 和激素受体的表达存在差异。所有病例均为 HER2 和 podoplanin 阴性。有 1 例患者观察到淋巴结转移。无病例因疾病死亡。
由于免疫组织化学分析在鉴别原发性皮肤大汗腺癌与乳腺癌皮肤转移方面缺乏特异性，因此需要详细的临床病史、乳房检查、充分的治疗和随访，以确认原发性皮肤大汗腺癌的诊断。
