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PRAME Immuno-Expression in Cutaneous Sebaceous Carcinoma: A Single Institutional Experience.

Gerardo Cazzato1, Anna Colagrande1, Giuseppe Ingravallo1

  • 1Section of Pathology, Department of Emergency and Organ Transplantation (DETO), University of Bari "Aldo Moro", 70124 Bari, Italy.

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Summary

Preferentially expressed Antigen in Melanoma (PRAME) shows limited diagnostic value for sebaceous carcinoma but may aid in subclassification by identifying sebaceous differentiation across WHO grades.

Keywords:
PRAMEdifferential diagnosisimmunohistochemistrymalignancypreferentially expressed antigen in melanomasebaceous carcinoma

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Area of Science:

  • Oncology
  • Dermatopathology
  • Immunohistochemistry

Background:

  • Preferentially expressed Antigen in Melanoma (PRAME) is a marker of interest in various neoplasms.
  • Its role in non-melanoma skin cancers (NMSC) is less explored compared to melanocytic lesions.

Purpose of the Study:

  • To evaluate the utility of PRAME immunostaining in the histopathological diagnosis and subclassification of sebaceous carcinoma (SC).
  • To correlate PRAME expression with different World Health Organization (WHO) grades of SC.

Main Methods:

  • Immunohistochemical analysis of PRAME expression was performed on 21 cases of sebaceous carcinoma (SC) graded I, II, and III.
  • Statistical analysis, including the Mann-Whitney test, was used to compare PRAME expression across SC grades.

Main Results:

  • PRAME positivity was observed in only 33.3% of SC cases.
  • PRAME expression was significantly higher in Grade I SC compared to Grade II (p < 0.0001) and Grade III (p = 0.0303), correlating with foci of sebaceous differentiation.
  • No significant difference in PRAME expression was found between Grade II and Grade III SC (p = 0.2028).

Conclusions:

  • PRAME does not appear to provide significant additional diagnostic information for sebaceous carcinoma compared to other markers like adipophylline.
  • PRAME may be useful in subcategorizing SC grades (I-III) by highlighting mature sebaceous differentiation, which is more prevalent in lower grades.