Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2015 Jan 30;5(1):43-6.
doi: 10.5826/dpc.0501a07. eCollection 2015 Jan.

Microcystic adnexal carcinoma of the cheek-a case report with dermatoscopy and dermatopathology

Mike Inskip  1 , Jill Magee  2
Affiliations

Microcystic adnexal carcinoma of the cheek-a case report with dermatoscopy and dermatopathology

Mike Inskip et al. Dermatol Pract Concept. .

Abstract

We present a case report of a microcystic adnexal carcinoma on the cheek of a 67-year-old man. Clinical, dermatoscopic and dermatopathologic images are presented. A search of the literature has not discovered any previously published dermatoscopy images of microcystic adenexal carcinoma.

Keywords: dermatoscopy; dermoscopy; microcystic adenexal carcinoma.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.
Clinical image of a non-pigmented skin lesion on the left mid cheek of a 67-year-old man. [Copyright: ©2014 Inskip, Magee.)
Figure 2.
Figure 2.
Dermatoscopy showing a dense white structureless area with fine linear branched blood vessels centrally. Note the white clods of variable diameter superiorly. (Copyright: ©2014 Inskip, Magee.)
Figure 3.
Figure 3.
Low power view demonstrates a poorly circumscribed, deeply invasive, infiltrative neoplasm, with superficial cyst formation and calcification, and a more morphoeiform desmoplastic deep component (Copyright: ©2014 Inskip, Magee.)
Figure 4.
Figure 4.
Intermediate power image shows superficial follicular differentiation with cysts and calcification, and more infiltrative deep component. (Copyright: ©2014 Inskip, Magee.)
Figure 5.
Figure 5.
Intermediate power of superficial follicular keratin-filled cysts. (Copyright: ©2014 Inskip, Magee.)
Figure 6.
Figure 6.
Intermediate power of superficial follicular keratin-filled cysts. (Copyright: ©2014 Inskip, Magee.)
Figure 7.
Figure 7.
High power of basaloid infiltrative aggregates in deeper portion of tumor. (Copyright: ©2014 Inskip, Magee.)
Figure 8.
Figure 8.
Focus of perineural invasion in deeper portion of tumor. (Copyright: ©2014 Inskip, Magee.)
Figure 9.
Figure 9.
Ber-Ep4 stain is strongly positive. This finding is not specific as Ber-Ep4 is positive in basal cell carcinoma. One study showed Ber-Ep4 positivity in 38% of microcystic adnexal carcinomas, 57% of desmoplastic trichoepitheliomas, 100% of basal cell carcinomas, and 38% of squamous carcinomas [6]. (Copyright: ©2014 Inskip, Magee.)
Figure 10.
Figure 10.
Cytokeratin 15 stain is also strongly positive. CK15 is a marker of the stem cells in the hair follicle bulge area. This finding favours microcystic adnexal carcinoma. Hoang et al found 92% of MAC and 100 % of desmoplastic trichoepitheliomata expressed CK15 whilst morphoeic BCC and squamous cell carcinomata were all negative. Thus this is a helpful marker to distinguish MAC from morphoeic BCC with adnexal differentiation [6]. (Copyright: ©2014 Inskip, Magee.)
Figure 11.
Figure 11.
CEA stain marks some of the ductular lumina within the aggregates. This is a marker of eccrine and apocrine ducts, which would favor microcystic adnexal carcinoma. (Copyright: ©2014 Inskip, Magee.)
See this image and copyright information in PMC

References

    1. Goldstein DJ, Barr RJ, Santa Cruz DJ. Microcystic adnexal carcinoma: a distinct clinicopathologic entity. Cancer. 1982;50:566–72. - PubMed
    1. McKinley LH, Seastrom S, Hanly AJ, Miller RA. Microcystic adnexal carcinoma: review of a potential diagnostic pitfall and management. Cutis. 2014;93(3):162–65. - PubMed
    1. Yu JB, Blitzblau RC, Patel SC, et al. Surveillance, Epidemiology, and End Results (SEER) database analysis of microcystic adnexal carcinoma (sclerosing sweat duct carcinoma) of the skin. Am J Clin Oncol. 2010;33(2):125–27. - PubMed
    1. Sánchez Armendáriz K, Toussaint Caire S, Gutiérrez Mendoza D, Fonte Ávalos V. Trichoepithelioma: a retrospective study 1993–2012—Dr Manuel Gea González General Hospital. Gac Med Mex. 2014;150(1):96–100. [Article in Spanish.] - PubMed
    1. Sidiropoulos M, Sade S, Al-Habeeb A, Ghazarian D. Syringoid eccrine carcinoma: a clinicopathological and immunohistochemical study of four cases. J Clin Pathol. 2011;64(9):788–92. - PubMed

LinkOut - more resources