1. Renal Cell Carcinoma Antigen Expression in Primary Cutaneous Endocrine Mucinous Carcinomas: A Case Series of 14 Patients and Review of the Literature
- Author
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Mark Chien-Chin Chen, Mattheos Bobos, Cecilia M Rosales, Nima Mesbah Ardakani, Tim Bracey, Phillip H. McKee, Ahmed Ansari, Shawn Shih, Christopher Savage, Chih-Jung Chen, and Carlos A. Cerruto
- Subjects
Male ,Pathology ,medicine.medical_specialty ,Dermal Neoplasm ,Dermatology ,Pathology and Forensic Medicine ,030207 dermatology & venereal diseases ,03 medical and health sciences ,0302 clinical medicine ,Dermis ,Antigens, Neoplasm ,Predictive Value of Tests ,Renal cell carcinoma ,Biomarkers, Tumor ,medicine ,Humans ,Endocrine system ,Aged ,Aged, 80 and over ,business.industry ,Papule ,Nodule (medicine) ,General Medicine ,Middle Aged ,medicine.disease ,Adenocarcinoma, Mucinous ,Immunohistochemistry ,Sweat Gland Neoplasms ,medicine.anatomical_structure ,Adenocarcinoma ,Female ,Mitogen-Activated Protein Kinases ,medicine.symptom ,business - Abstract
Endocrine mucin-producing sweat gland carcinoma (EMPSGC) and primary cutaneous mucinous carcinoma (PCMC) are both uncommon low-grade cutaneous adnexal tumors with predilection for the eyelids of elderly women. Their clinical appearance is nonspecific, typically presenting as a slowly growing poorly circumscribed papule, nodule, plaque, or swelling. Histological features of EMPSGC include a lobulated dermal neoplasm with bland cytology and an invasive mucinous component in up to half of the cases. PCMC exhibits tumor nests suspended in abundant pools of mucin with focal strands or nests of tumor cells infiltrating the dermis. Because of their rarity and banal cytological features, both entities pose a risk for misdiagnosis with other benign/malignant cutaneous adnexal neoplasms. Histomorphological features can suggest a diagnosis of EMPSGC or PCMC, but immunohistochemistry is necessary for confirmation. A review of the literature showed variable results of antigens present in EMPSGC, and many of the positive markers only show sparse or focal immunoreactivity of tumor cells. As a result, diffusely positive markers play a crucial role in identification of these tumors, particularly with initial superficial biopsies. We present 9 cases of EMPSGC and 5 cases of PCMC with strong and diffuse immunoreactivity to renal cell carcinoma antigen. This novel finding can be useful in the diagnosis of EMPSGC and PCMC in combination with other known positive markers to differentiate them from other cutaneous neoplasms. In addition, it provides further evidence that EMPSGC could be a precursor lesion to PCMC with both existing on a spectrum.
- Published
- 2019