Primary cutaneous apocrine carcinoma: A challenging case report

Area of Science:

• Dermatology
• Oncology
• Pathology

Background:

• Primary cutaneous apocrine carcinomas are rare adnexal tumors.
• Distinguishing them from breast cancer metastases is diagnostically challenging.
• Fewer than 200 cases have been reported in the literature.

Observation:

• A 58-year-old man presented with a large axillary mass.
• Initial biopsy suggested metastatic breast cancer, but imaging and tumor markers were negative.
• Histopathology and immunohistochemistry confirmed primary cutaneous apocrine adenocarcinoma.

Findings:

• The axillary tumor exhibited high CK7 expression and negative expression for TTF1, RH, PSA, and CK20.
• This immunoprofile aided in differentiating it from metastatic disease.
• The patient underwent surgical excision and axillary lymph node dissection.

Implications:

• This case highlights the importance of clinico-pathological correlation in diagnosing rare skin cancers.
• Careful histological analysis and clinical presentation are crucial for accurate diagnosis.
• Standard treatment involves wide local excision, potentially with lymph node dissection.