Department of Dermatologic Oncology, National Cancer Center Hospital, Tokyo, Japan.
Department of Dermatology, Faculty of Medicine, Saga University, Saga, Japan.
Jpn J Clin Oncol. 2024 Nov 2;54(11):1135-1140. doi: 10.1093/jjco/hyae103.
Cutaneous apocrine carcinoma is a rare skin cancer arising from apocrine sweat glands. Disease-specific treatments are required for cutaneous adnexal carcinomas due to their heterogeneous treatment responsiveness. This review reports on the epidemiology, diagnosis, pathological features, surgical management, and use of systemic therapies for cutaneous apocrine carcinoma. Diagnosing cutaneous apocrine carcinoma requires presenting with distinctive pathological features and excluding metastatic adenocarcinomas, particularly breast cancer. Clinical findings are essential to exclude metastatic adenocarcinomas, and immunohistochemistry can be used as an adjunctive tool to rule out other diseases. Wide local excision is the standard treatment for resectable cutaneous apocrine carcinomas. Prophylactic lymphadenectomy should be considered as a treatment option given the high incidence of lymph node metastasis. Generally, cutaneous apocrine carcinomas are resistant to chemotherapy and radiation therapy; however, adjuvant radiotherapy is recommended for high-risk patients. Radiation or systemic therapy is administered to patients with distant metastases or recurrence. The systemic therapeutic options include cytotoxic chemotherapy, hormonal therapy, targeted therapy, and immune checkpoint inhibitors. Given the lack of data on clinical prognosis and standardized treatments, further studies are needed to improve our understanding of cutaneous apocrine carcinomas.
皮肤大汗腺癌是一种罕见的皮肤癌，起源于大汗腺。由于皮肤附件癌的治疗反应存在异质性，因此需要针对特定疾病的治疗方法。本综述报告了皮肤大汗腺癌的流行病学、诊断、病理特征、手术管理以及全身治疗的应用。诊断皮肤大汗腺癌需要具有独特的病理特征，并排除转移性腺癌，特别是乳腺癌。临床发现对于排除转移性腺癌至关重要，免疫组织化学可作为辅助工具排除其他疾病。广泛局部切除是可切除的皮肤大汗腺癌的标准治疗方法。鉴于淋巴结转移的高发生率，预防性淋巴结切除术应被视为一种治疗选择。一般来说，皮肤大汗腺癌对化疗和放疗具有耐药性；然而，对于高危患者，建议辅助放疗。对于有远处转移或复发的患者，给予放疗或全身治疗。全身治疗选择包括细胞毒性化疗、激素治疗、靶向治疗和免疫检查点抑制剂。鉴于缺乏关于临床预后和标准化治疗的数据，需要进一步的研究来加深我们对皮肤大汗腺癌的认识。
