具有微囊肿性附属器癌样结构特征的高分化附属器癌

作     者：Fernndez-Figueras M.-T. Montero M.-A. Admella J. 李晓莉 

作者机构：Hospital Universitari Germans Trias I Pujol Carretera Canyet s/n 08916 Badalona Barcelona SpainDr. 

出 版 物：《世界核心医学期刊文摘（皮肤病学分册）》 (Digest of the World Core Medical JOurnals:Dermatology)

年 卷 期：2006年第2卷第11期

页      面：36-37页

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

主　　题：附属器 微囊肿 汗腺肿瘤 局部淋巴结 局部侵袭性 鳞状细胞 局部切除 神经束膜 蛋白免疫 小囊 

摘      要：Microcystic adnexal carcinoma (MAC) is a slow growing, locally aggressive sweat gland tumor. It predominantly affects the face and tends to recur despite local excision. Microscopically, MAC is characterized by a stratified proliferation of microcysts, cords, and ducts of cells that show squamous or adnexal differentiation. Atypia andmitoses are almost completely absent and metastatic deposits are rare and mostly limited to the regional lymph nodes; rather than real metastases, they might be the result of local extension of the tumor through perineurial spaces. We report a case of adnexal carcinoma with architectural features of MAC that displayed also marked nuclear pleomorphism and hyperchromasia with squamous pearl formation and a widespread strong p53 immunoreaction. The lesion behaved as a high-grade neoplasmwith rapid growth, carcinosarcomatous metaplastic transformation in a relapse, and what were clinically suspected to be metastases. The literature contains several other examples reported as metastatic highgrade MAC, one of them with widespread distant metastases. We therefore want to sound an alert about the possible existence of tumors displaying microscopic findings characteristic of the aggressive forms of sweat gland carcinoma (nuclear pleomorphism and hyperchromasia, vascular invasion, and necrosis) in addition to architectural features of MAC. Whether these tumors should be called high-gradeMACs or belong to a separate category remains an open issue until more cases are reported and bridge cases are eventually documented.