Apocrine adenocarcinoma is a rare form of sweat gland malignancy mostly affecting adults without evident prevalence for sex or race. Clinically, it presents as a single or a multi-nodular mass or plaque in the axillary or anogenital region, with no additional symptoms. This neoplasm is locally invasive, grows slowly and has an ability to metastasize to visceral organs, regional lymph nodes and bones. We report a case of infiltrating apocrine adenocarcinoma on the scrotum and pubic area with extramammary pagetoid spread into the groin. The immunohistological staining patterns suggested that both extramammary Paget’s disease and apocrine adenocarcinoma derived from the apocrine gland, because the tumor cells were positive for cytokeratin (CK) 7 and gross cystic disease fluid protein-15 (GCDFP-15), but negative for CK20 and prostate-specific antigen (PSA). The results of this case study will facilitate the understanding of this malignant tumor.
1. Requena L, Kutzner H, Hurt MA, SantaCruz DJ, Mehregan DA, Mehregan DR, et al. Malignant tumours with apocrine and eccrine differentiation. In: LeBoit PE, Burg G, Weedon D, Sarasin A, editors. World Health Organization classification of tumours. Pathology and genetics of skin tumours. 3rd ed. Lyon: IARC Press; 2006. p. 125-38.
2. Hollowell KL, Agle SC, Zervos EE, Fitzgerald TL. Cutaneous apocrine adenocarcinoma: defining epidemiology, outcomes, and optimal therapy for a rare neoplasm. J Surg Oncol. 2012;105(4):415-9.
3. Paties C, Taccagni GL, Papotti M, Valente G, Zangrandi A, Aloi F. Apocrine carcinoma of the skin. A clinicopathologic, immunocytochemical, and ultrastructural study. Cancer. 1993;71(2):375-81.
4. Pai RR, Kini JR, Achar C, Rau A, Kini H. Apocrine (cutaneous) sweat gland carcinoma of axilla with signet ring cells. A diagnostic dilemma on fine-needle aspiration cytology. Diagn Cytopathol. 2008;36(10):739-41.
5. Bowling JC, Powles A, Nasiri N, Searle A, Bunker CB. Spontaneous regression of extramammary Paget’s disease after excision of primary apocrine carcinoma, in an immunosuppressed patient. Br J Dermatol. 2005;153(3):676-7.
6. Hernandez JM, Copeland EM 3rd. Infiltrating apocrine adenocarcinoma with extramammary pagetoid spread. Am Surg. 2007;73(3):307-9.
7. Pascual JC, Perez-Ramos M, Devesa JP, Kutzner H, Requena L. Extramammary Paget’s disease of the groin with underlying carcinoma and fatal outcome. Clin Exp Dermatol. 2008;33(5):595-8.
8. Seo SH, Shin DH, Sung HW. Apocrine carcinoma of the groin possibly associated with extramammary Paget’s disease. Ann Dermatol. 2011;23(4):519-22.
9. Robson A, Lazar AJ, Ben Nagi J, Hanby A, Grayson W, Feinmesser M, et al. Primary cutaneous apocrine carcinoma: a clinico-pathologic analysis of 24 cases. Am J Surg Pathol. 2008;32(5):682-90.
10. Zollo JD, Zeitouni NC. The Roswell Park Cancer Institute experience with extramammary Paget’s disease. Br J Dermatol. 2000;142(1):59-65.
11. Payne WG, Wells KE. Extramammary Paget’s disease of the scrotum. Ann Plast Surg. 1994;33(6):669-71.
12. Juang GD, Lin MY, Hwang TI. Extramammary Paget’s disease of the scrotum. J Chin Med Assoc. 2011;74(7):325-8.
13. Fernandez-Flores A. Immunohistochemical and morphologic evaluation of primary cutaneous apocrine carcinomas and cutaneous metastases from ductal breast carcinoma. Rom J Morphol Embryol. 2012;53(4):879-92.