Soughi Meryem, Elloudi Sara, Ardigo Marco, Baybay Hanane, Mernissi FatimaZahra
Deparment of Dermatology, Centre Hospitalier Universitaire Hassan II, Fez, MAR.
Faculty of Medicine, Pharmacy, and Dental Medicine, Sidi Mohamed Ben Abdellah University, Fez, MAR.
Cureus. 2024 Jul 11;16(7):e64318. doi: 10.7759/cureus.64318. eCollection 2024 Jul.
Primary cutaneous adenoid cystic carcinoma (PCACC) is a rare, slow-growing adnexal skin tumor with about 250 documented cases. We present a case involving a 66-year-old woman who was treated with ovulation inductors 30 years ago and underwent surgeries for meningioma 20 years ago and invasive galactophoric adenocarcinoma of the left breast 12 years ago. She presented with a gradually enlarging, solid, skin-colored tumor on her scalp, located along an old surgical scar initially diagnosed as a keloid by her surgeon. Clinical and dermoscopic evaluations suggested basal cell carcinoma or a metastatic tumor. Confocal microscopy showed deep infiltration without specific diagnostic clues. However, histopathological examination, immunohistochemistry, and comprehensive investigations confirmed the diagnosis of PCACC. A wide local excision was performed, with no recurrence noted during the two-year follow-up. This case highlights the challenges of diagnosing PCACC through clinical, dermoscopic, and confocal methods. Histological analysis remains essential, particularly to distinguish it from metastatic lesions, emphasizing the need for a thorough diagnostic approach in such cases.
原发性皮肤腺样囊性癌（PCACC）是一种罕见的、生长缓慢的附属器皮肤肿瘤，有记录的病例约250例。我们报告一例66岁女性病例，该患者30年前接受过促排卵治疗，20年前接受过脑膜瘤手术，12年前接受过左乳浸润性导管腺癌手术。她头皮上出现一个逐渐增大的实性肤色肿瘤，位于一条旧手术瘢痕处，最初她的外科医生诊断为瘢痕疙瘩。临床和皮肤镜检查提示为基底细胞癌或转移性肿瘤。共聚焦显微镜检查显示深部浸润，但无特异性诊断线索。然而，组织病理学检查、免疫组化和综合检查确诊为PCACC。进行了广泛的局部切除，在两年随访期间未发现复发。该病例突出了通过临床、皮肤镜和共聚焦方法诊断PCACC的挑战。组织学分析仍然至关重要，特别是要将其与转移性病变区分开来，强调在此类病例中需要采取全面的诊断方法。
