Skip to main content

Advertisement

SpringerLink
Log in

Sclerosing Microcystic Adenocarcinoma of the Head and Neck Mucosa: A Neoplasm Closely Resembling Microcystic Adnexal Carcinoma

  • Original Paper
  • Published:
Head and Neck Pathology Aims and scope Submit manuscript

Abstract

Microcystic adnexal carcinoma (MAC) occurs predominantly in the centrofacial skin and has been only rarely reported in mucosal surfaces. We here present a 5 case series of tumors closely resembling MAC occurring in the mucosal surfaces of the head and neck, which we have termed sclerosing microcystic adenocarcinomas. These tumors showed a predilection for women (4:1) with an average patient age of 52.6 years (range 41–73 years). Location included the tongue (n = 2), the floor of the mouth (n = 2), and the nasopharynx/clivus (n = 1). One occurred after radiation therapy and another occurred in the setting of immune compromise. Immunohistochemistry highlighted a dual cell population with luminal cells showing positivity for high and low-molecular weight keratins and surrounding myoepithelial cells showing S100 and smooth muscle actin staining. No cases had nodal involvement, and the single patient with clinical follow-up was alive and free of disease 34 months after diagnosis and definitive radiochemotherapy. Differential diagnoses for all cases diverged from those provoked by MAC in the skin and included a variety of salivary gland neoplasms such as adenoid cystic carcinoma, polymorphous low grade adenocarcinoma, and mucoepidermoid carcinoma. Recognition of sclerosing microcystic adenocarcinoma in the head and neck mucosa is critical given its bland appearance and subtle infiltration pattern, infrequency of nodal involvement, and behavioral differences from the other entities on the differential.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Abbate M, Zeitouni NC, Seyler M, Hicks W, Loree T, Cheney RT. Clinical course, risk factors, and treatment of microcystic adnexal carcinoma: a short series report. Dermatol Surg. 2003;29(10):1035–8.

    PubMed  Google Scholar 

  2. Goldstein DJ, Barr RJ, Santa Cruz DJ. Microcystic adnexal carcinoma: a distinct clinicopathologic entity. Cancer. 1982;50(3):566–72.

    Article  CAS  PubMed  Google Scholar 

  3. LeBoit PE, Sexton M. Microcystic adnexal carcinoma of the skin. A reappraisal of the differentiation and differential diagnosis of an underrecognized neoplasm. J Am Acad Dermatol. 1993;29(4):609–18.

    Article  CAS  PubMed  Google Scholar 

  4. Friedman PM, Friedman RH, Jiang SB, Nouri K, Amonette R, Robins P. Microcystic adnexal carcinoma: collaborative series review and update. J Am Acad Dermatol. 1999;41(2 Pt 1):225–31.

    Article  CAS  PubMed  Google Scholar 

  5. Kato H, Mizuno N, Nakagawa K, Furukawa M, Hamada T. Microcystic adnexal carcinoma: a light microscopic, immunohistochemical and ultrastructural study. J Cutan Pathol. 1990;17(2):87–95.

    Article  CAS  PubMed  Google Scholar 

  6. Cooper PH. Sclerosing carcinomas of sweat ducts (microcystic adnexal carcinoma). Arch Dermatol. 1986;122(3):261–4.

    Article  CAS  PubMed  Google Scholar 

  7. Buhl A, Landow S, Lee YC, Holcomb K, Heilman E, Abulafia O. Microcystic adnexal carcinoma of the vulva. Gynecol Oncol. 2001;82(3):571–4. doi:10.1006/gyno.2001.6300.

    Article  CAS  PubMed  Google Scholar 

  8. Yavuzer R, Boyaci M, Sari A, Ataoglu O. Microcystic adnexal carcinoma of the breast: a very rare breast skin tumor. Dermatol Surg. 2002;28(11):1092–4.

    PubMed  Google Scholar 

  9. Schipper JH, Holecek BU, Sievers KW. A tumour derived from ebner’s glands: microcystic adnexal carcinoma of the tongue. J Laryngol Otol. 1995;109(12):1211–4.

    Article  CAS  PubMed  Google Scholar 

  10. Hunt JT, Stack BC Jr, Futran ND, Glass LF, Endicott JN. Pathologic quiz case 1. microcystic adnexal carcinoma (MAC). Arch Otolaryngol Head Neck Surg. 1995;121(12):1430–3.

    Article  CAS  PubMed  Google Scholar 

  11. Wick MR, Cooper PH, Swanson PE, Kaye VN, Sun TT. Microcystic adnexal carcinoma. An immunohistochemical comparison with other cutaneous appendage tumors. Arch Dermatol. 1990;126(2):189–94.

    Article  CAS  PubMed  Google Scholar 

  12. Requena L, Marquina A, Alegre V, Aliaga A, Sanchez Yus E. Sclerosing-sweat-duct (microcystic adnexal) carcinoma—a tumor from a single eccrine origin. Clin Exp Dermatol. 1990;15(3):222–4.

    Article  CAS  PubMed  Google Scholar 

  13. Ackerman AB, Briggs PL, Bravo F. Differential diagnosis in dermatopathology. 1st ed. Philadelphia: Lea & Febiger; 1993. p. 86.

    Google Scholar 

  14. Heenan PJ. Sebaceous differentiation in microcystic adnexal carcinoma. Am J Dermatopathol. 1998;20(5):537–8.

    Article  CAS  PubMed  Google Scholar 

  15. Krahl D, Sellheyer K. Monoclonal antibody ber-EP4 reliably discriminates between microcystic adnexal carcinoma and basal cell carcinoma. J Cutan Pathol. 2007;34(10):782–7.

    Article  PubMed  Google Scholar 

  16. Schwarze HP, Loche F, Lamant L, Kuchta J, Bazex J. Microcystic adnexal carcinoma induced by multiple radiation therapy. Int J Dermatol. 2000;39(5):369–72.

    Article  CAS  PubMed  Google Scholar 

  17. Antley CA, Carney M, Smoller BR. Microcystic adnexal carcinoma arising in the setting of previous radiation therapy. J Cutan Pathol. 1999;26(1):48–50.

    Article  CAS  PubMed  Google Scholar 

  18. Lei JY, Wang Y, Jaffe ES, et al. Microcystic adnexal carcinoma associated with primary immunodeficiency, recurrent diffuse herpes simplex virus infection, and cutaneous T-cell lymphoma. Am J Dermatopathol. 2000;22(6):524–9.

    Article  CAS  PubMed  Google Scholar 

  19. Carroll P, Goldstein GD, Brown CW Jr. Metastatic microcystic adnexal carcinoma in an immunocompromised patient. Dermatol Surg. 2000;26(6):531–4.

    Article  CAS  PubMed  Google Scholar 

  20. Moskaluk CA. Adenoid cystic carcinoma: clinical and molecular features. Head Neck Pathol. 2013;7(1):17–22. doi:10.1007/s12105-013-0426-3.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Thompson LD, Penner C, Ho NJ, et al. Sinonasal tract and nasopharyngeal adenoid cystic carcinoma: a clinicopathologic and immunophenotypic study of 86 cases. Head Neck Pathol. 2014;8(1):88–109. doi:10.1007/s12105-013-0487-3.

    Article  PubMed  Google Scholar 

  22. Gnepp DR, Chen JC, Warren C. Polymorphous low-grade adenocarcinoma of minor salivary gland. An immunohistochemical and clinicopathologic study. Am J Surg Pathol. 1988;12(6):461–8.

    Article  CAS  PubMed  Google Scholar 

  23. Thompson LD. Polymorphous low-grade adenocarcinoma. Ear Nose Throat J. 2014;93(1):24–5.

    PubMed  Google Scholar 

  24. Brandwein MS, Ivanov K, Wallace DI, et al. Mucoepidermoid carcinoma: a clinicopathologic study of 80 patients with special reference to histological grading. Am J Surg Pathol. 2001;25(7):835–45.

    Article  CAS  PubMed  Google Scholar 

  25. Connor A, Perez-Ordonez B, Shago M, Skalova A, Weinreb I. Mammary analog secretory carcinoma of salivary gland origin with the ETV6 gene rearrangement by FISH: expanded morphologic and immunohistochemical spectrum of a recently described entity. Am J Surg Pathol. 2012;36(1):27–34. doi:10.1097/PAS.0b013e318231542a.

    Article  PubMed  Google Scholar 

  26. Smith KJ, Williams J, Corbett D, Skelton H. Microcystic adnexal carcinoma: an immunohistochemical study including markers of proliferation and apoptosis. Am J Surg Pathol. 2001;25(4):464–71.

    Article  CAS  PubMed  Google Scholar 

  27. Weinreb I. Translocation-associated salivary gland tumors: a review and update. Adv Anat Pathol. 2013;20(6):367–77. doi:10.1097/PAP.0b013e3182a92cc3.

    Article  PubMed  Google Scholar 

  28. Seethala RR, Dacic S, Cieply K, Kelly LM, Nikiforova MN. A reappraisal of the MECT1/MAML2 translocation in salivary mucoepidermoid carcinomas. Am J Surg Pathol. 2010;34(8):1106–21. doi:10.1097/PAS.0b013e3181de3021.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Pathology, University of Virginia, Charlottesville, VA, USA

    Anne M. Mills, Mark R. Wick & Stacey E. Mills

  2. University of Texas Health Science Center, San Antonio, TX, USA

    Maria Luisa C. Policarpio-Nicholas

  3. Department of Pathology, University of Erlangen, Erlangen, Germany

    Abbas Agaimy

Authors
  1. Anne M. Mills
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Maria Luisa C. Policarpio-Nicholas
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Abbas Agaimy
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Mark R. Wick
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Stacey E. Mills
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Anne M. Mills.

Ethics declarations

Conflict of interest

The authors have no conflicts of interest to disclose.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Mills, A.M., Policarpio-Nicholas, M.L.C., Agaimy, A. et al. Sclerosing Microcystic Adenocarcinoma of the Head and Neck Mucosa: A Neoplasm Closely Resembling Microcystic Adnexal Carcinoma. Head and Neck Pathol 10, 501–508 (2016). https://doi.org/10.1007/s12105-016-0731-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12105-016-0731-8

Keywords

Search

Navigation