Abstract
Microcystic adnexal carcinoma is most frequently located in the skin of the nasolabial and periorbital region.
Histopathologically, the neoplasm shows three components, which are usually arranged in a horizontal stratified way: The upper part of the is composed of small cystic keratinized structures similar to milia cysts surrounded by pale cells or keratinized cells; in the center of the lesion, there are solid aggregates of pale or eosinophilic cells of variable size and shape which are predominant; and, finally, in the deepest portion, there are tubular structures, lined by a double layer of epithelial cells and containing a homogeneous eosinophilic material. The luminal cells of these tubules occasionally show decapitation secretion. Cytologically, this neoplasm does not show cellular atypia and mitotic figures are rare. Perineural involvement is frequent in deeper areas.
Immunohistochemically neoplastic cells express CK15, whereas CEA and EMA stain ductal structures.
Microcystic adnexal carcinoma is a neoplasm of slow growth, locally destructive but with very low metastatic potential.
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Goldstein DJ, Barr RJ, Santa Cruz DJ. Microcystic adnexal carcinoma: a distinct clinicopathologic entity. Cancer. 1982;50:566–72.
Cooper PH, Mills SE. Microcystic adnexal carcinoma. J Am Acad Dermatol. 1984;10:908–14.
Fleischmann HE, Roth RJ, Wood C, Nickoloff BJ. Microcystic adnexal carcinoma treated by microscopically controlled excision. J Dermatol Surg Oncol. 1984;10:873–5.
Nickoloff BJ, Fleischmann HE, Carmel J, Wood CC, Roth RJ. Microcystic adnexal carcinoma. Immunohistologic observations suggesting dual (pilar and eccrine) differentiation. Arch Dermatol. 1986;122:290–4.
Cooper PH. Sclerosing carcinomas of sweat ducts (microcystic adnexal carcinoma). Arch Dermatol. 1986;122:261–4.
Lupton GP, McMarlin SL. Microcystic adnexal carcinoma. Report of a case with 30-year follow-up. Arch Dermatol. 1986;122:286–9.
Hamm JC, Argenta LC, Swanson NA. Microcystic adnexal carcinoma: an unpredictable aggressive neoplasm. Ann Plast Surg. 1987;19:173–80.
Ceballos PI, Penneys NS, Cohen BH. Microcystic adnexal carcinoma: a case showing eccrine duct differentiation. J Dermatol Surg Oncol. 1988;14:1236–9.
Birkby CS, Argenyi ZB, Whitaker DC. Microcystic adnexal carcinoma with mandibular invasion and bone marrow replacement. J Dermatol Surg Oncol. 1989;15:308–12.
Miyamoto T, Kambe N, Nishiura S, Mihara M, Shimao S. Microcystic adnexal carcinoma. Electron microscopic and immunohistochemical study. Dermatologica. 1990;180:40–3.
Wick MR, Cooper PH, Swanson PE, Kaye VN, Sun TT. Microcystic adnexal carcinoma. An immunohistochemical comparison with other cutaneous appendage tumors. Arch Dermatol. 1990;126:189–94.
Kato H, Mizuno N, Nakagawa K, Furukawa M, Hamada T. Microcystic adnexal carcinoma: a light microscopic, immunohistochemical and ultrastructural study. J Cutan Pathol. 1990;17:87–95.
Cortelazzi R, Politi M, Consolo U, Bonetti F, Colombari R. Il carcinoma microcistico annessiale. Descrizione di un caso. Minerva Stomatol. 1990;39:529–33.
Borenstein A, Seidman DS, Trau H, Tsur H. Microcystic adnexal carcinoma following radiotherapy in childhood. Am J Med Sci. 1991;301:259–61.
Yuh WT, Engelken JD, Whitaker DC, Dolan KD. Bone marrow invasion of microcystic adnexal carcinoma. Ann Otol Rhinol Laryngol. 1991;100:601–3.
Martin PC, Smith JL, Pulitzer DR, Reed RJ. Compound (primordial) adnexal carcinoma arising in a systematized compound epithelial nevus. Am J Surg Pathol. 1992;16:417–25.
Sebastien TS, Nelson BR, Lowe L, Baker S, Johnson TM. Microcystic adnexal carcinoma. J Am Acad Dermatol. 1993;29:840–5.
Lober CW, Larbig GG. Microcystic adnexal carcinoma (sclerosing sweat duct carcinoma). South Med J. 1994;87:259–62.
Burns MK, Chen SP, Goldberg LH. Microcystic adnexal carcinoma. Ten cases treated by Mohs micrographic surgery. J Dermatol Surg Oncol. 1994;20:429–34.
Yoon HK, Park SM, Joo JE. Combined microcystic adnexal carcinoma and squamous cell carcinoma arising in the ovarian cystic teratoma – a brief case report. J Korean Med Sci. 1994;9:432–5.
Hazen PG, Bass J. Microcystic adnexal carcinoma: successful management using Mohs’ micrographically-controlled surgery. Int J Dermatol. 1994;33:801–2.
Pujol RM, LeBoit PE, Su WP. Microcystic adnexal carcinoma with extensive sebaceous differentiation. Am J Dermatopathol. 1997;19:358–62.
Yugueros P, Kane WJ, Goellner JR. Sweat gland carcinoma: a clinicopathologic analysis of an expanded series in a single institution. Plast Reconstr Surg. 1998;102:705–10.
Antley CA, Carney M, Smoller BR. Microcystic adnexal carcinoma arising in the setting of previous radiation therapy. J Cutan Pathol. 1999;26:48–50.
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;41:225–31.
Carroll P, Goldstein GD, Brown Jr CW. Metastatic microcystic adnexal carcinoma in an immunocompromised patient. Dermatol Surg. 2000;26:531–4.
Schwarze HP, Loche F, Lamant L, Kuchta J, Bazex J. Microcystic adnexal carcinoma induced by multiple radiation therapy. Int J Dermatol. 2000;39:369–72.
Chiller K, Passaro D, Scheuller M, Singer M, McCalmont T, Grekin RC. Microcystic adnexal carcinoma: forty-eight cases, their treatment, and their outcome. Arch Dermatol. 2000;136:1355–9.
Peterson CM, Ratz JL, Sangueza OP. Microcystic adnexal carcinoma: first reported case in an African American man. J Am Acad Dermatol. 2001;45:283–5.
Ohtsuka H, Nagamatsu S. Microcystic adnexal carcinoma: review of 51 Japanese patients. Dermatology. 2002;204:190–3.
Callahan EF, Vidimos AT, Bergfeld WF. Microcystic adnexal carcinoma (MAC) of the scalp with extensive pilar differentiation. Dermatol Surg. 2002;28:536–9.
Wertheimer FW, Mintz SM. Solitary trichoepithelioma of the upper lip: report of a case. J Oral Surg. 1972;30:215–6.
Kelly DE, Klein KM, Harrigan WF. Lip reconstruction following resection for an unusual basal-cell carcinoma. Oral Surg. 1975;40:19–26.
Gulmen S, Pullon PA. Sweat gland carcinoma of the lips. Oral Surg. 1976;41:643–9.
Apisarnthanarax P, Bovenmyer DA, Mehregan AH. Combined adnexal tumor of the skin. Arch Dermatol. 1984;120:231–3.
Cooper PH, Mills SE, Leonard DD, Santa Cruz DJ, Headington JT, Barr RJ, Katz DA. Sclerosing sweat duct (syringomatous) carcinoma. Am J Surg Pathol. 1985;9:422–33.
Rosen PP. Syringomatous adenoma of the nipple. Am J Surg Pathol. 1983;7:739–45.
Biernat W, Jablkowski W. Syringomatous adenoma of the nipple. Pol J Pathol. 2000;51:201–2.
Ward BE, Cooper PH, Subramony C. Syringomatous tumor of the nipple. Am J Clin Pathol. 1989;92:692–6.
Suster S, Moran CA, Hurt MA. Syringomatous squamous tumors of the breast. Cancer. 1991;67:2350–5.
Hodgson TA, Haricharan AK, Barrett AW, Porter SR. Microcystic adnexal carcinoma: an unusual cause of swelling and paraesthesia of the lower lip. Oral Oncol. 2003;39:195–8.
Stein JM, Ormsby A, Esclamado R, Bailin P. The effect of radiation therapy on microcystic adnexal carcinoma: a case report. Head Neck. 2003;25:251–4.
Rotter N, Wagner H, Fuchshuber S, Issing WJ. Cervical metastases of microcystic adnexal carcinoma in an otherwise healthy woman. Eur Arch Otorhinolaryngol. 2003;260:254–7.
Ban M, Sugie S, Kamiya H, Kitajima Y. Microcystic adnexal carcinoma with lymph node metastasis. Dermatology. 2003;207:395–7.
Ohta M, Hiramoto M, Ohtsuka H. Metastatic microcystic adnexal carcinoma: an autopsy case. Dermatol Surg. 2004;30:957–60.
Leibovitch I, Huilgol SC, Selva D, Lun K, Richards S, Paver R. Microcystic adnexal carcinoma: treatment with Mohs micrographic surgery. J Am Acad Dermatol. 2005;52:295–300.
Khachemoune A, Olbricht SM, Johnson DS. Microcystic adnexal carcinoma: report of four cases treated with Mohs’ micrographic surgical technique. Int J Dermatol. 2005;44:507–12.
Leibovitch I, Huilgol SC, Richards S, Paver R, Selva D. Periocular microcystic adnexal carcinoma: management and outcome with Mohs’ micrographic surgery. Ophthalmologica. 2006;220:109–13.
Gabillot-Carré M, Weill F, Mamelle G, Kolb F, Boitier F, Petrow P, Ortoli JC, Margulis A, Souteyrand P, Mercier S, Spatz A, Duvillard P, Validire P, Avril MF. Microcystic adnexal carcinoma: report of seven cases including one with lung metastasis. Dermatology. 2006;212:221–8.
Fernández-Figueras MT, Montero MA, Admella J, de la Torre N, Quer A, Ariza A. High (nuclear) grade adnexal carcinoma with microcystic adnexal carcinoma-like structural features. Am J Dermatopathol. 2006;28:346–51.
Nagatsuka H, Rivera RS, Gunduz M, Siar CH, Tamamura R, Mizukawa N, Asaumi J, Nagai N. Microcystic adnexal carcinoma with mandibular bone marrow involvement: a case report with immunohistochemistry. Am J Dermatopathol. 2006;28:518–22.
Page RN, Hanggi MC, King R, Googe PB. Multiple microcystic adnexal carcinomas. Cutis. 2007;79:299–303.
Wang SQ, Goldberg LH, Nemeth A. The merits of adding toluidine blue-stained slides in Mohs surgery in the treatment of a microcystic adnexal carcinoma. J Am Acad Dermatol. 2007;56:1067–9.
Krahl D, Sellheyer K. Monoclonal antibody Ber-EP4 reliably discriminates between microcystic adnexal carcinoma and basal cell carcinoma. J Cutan Pathol. 2007;34:782–7.
Nadiminti H, Nadiminti U, Washington C. Microcystic adnexal carcinoma in African-Americans. Dermatol Surg. 2007;33:1384–7.
Hoang MP, Dresser KA, Kapur P, High WA, Mahalingam M. Microcystic adnexal carcinoma: an immunohistochemical reappraisal. Mod Pathol. 2008;21:178–85.
Gomez-Maestra MJ, España-Gregori E, Aviñó-Martinez JA, Mancheño-Franch N, Peña S. Brainstem and cavernous sinus metastases arising from a microcystic adnexal carcinoma of the eyebrow by perineural spreading. Can J Ophthalmol. 2009;44:e17–8.
Martorell-Calatayud A, Requena-Caballero C, Botella-Estrada R, Almenar-Medina S, Sanmartín-Jiménez O, Llombart-Cussac B, Nagore-Enguídanos E, Serra-Guillén C, Echeverría-García B, Guillén-Barona C. Carcinoma anexial microquístico: la cirugía micrografica de Mohs como tratamiento de elección. Actas Dermosifiliogr. 2009;100:693–9.
Kavand S, Cassarino DS. “Squamoid eccrine ductal carcinoma”: an unusual low-grade case with follicular differentiation. Are these tumors squamoid variants of microcystic adnexal carcinoma? Am J Dermatopathol. 2009;31:849–52.
Palamaras I, McKenna JD, Robson A, Barlow RJ. Microcystic adnexal carcinoma: a case series treated with Mohs micrographic surgery and identification of patients in whom paraffin sections may be preferable. Dermatol Surg. 2010;36:446–52.
Baxi S, Deb S, Weedon D, Baumann K, Poulsen M. Microcystic adnexal carcinoma of the skin: the role of adjuvant radiotherapy. J Med Imaging Radiat Oncol. 2010;54:477–82.
Kazakov DV, Kacerovska D, Michal M. Microcystic adnexal carcinoma with multiple areas of follicular differentiation toward germinative cells and specific follicular stroma (trichoblastomatous areas). Am J Dermatopathol. 2011;33:e47–9.
Smart DR, Taintor AR, Kelly ME, Lyon VB, Segura A, Jensen JN, Drolet BA. Microcystic adnexal carcinoma: the first reported congenital case. Pediatr Dermatol. 2011;28:35–8.
Fu T, Clark FL, Lorenz HP, Bruckner AL. Congenital microcystic adnexal carcinoma. Arch Dermatol. 2011;147:256–7.
Pugh TJ, Lee NY, Pacheco T, Raben D. Microcystic adnexal carcinoma of the face treated with radiation therapy: a case report and review of the literature. Head Neck. 2012;34:1045–50.
Liang CA, Busam KJ, Nehal KS. Microcystic adnexal carcinoma associated with multiple benign syringomatous proliferations: a report of two cases. Dermatol Surg. 2011;37:1515–8.
Ide F, Kikuchi K, Kusama K. Microcystic adnexal (sclerosing sweat duct) carcinoma of intraoral minor salivary gland origin: an extracutaneous adnexal neoplasm? Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2011;112:284–6.
Weissferdt A, Moran CA. Microcystic squamous cell carcinoma of the lung: a clinicopathologic study of three cases. Am J Clin Pathol. 2011;136:436–41.
Tse JY, Nguyen AT, Le LP, Hoang MP. Microcystic adnexal carcinoma versus desmoplastic trichoepithelioma: a comparative study. Am J Dermatopathol. 2013;35:50–5.
Rustemeyer J, Zwerger S, Pörksen M, Junker K. Microcystic adnexal carcinoma of the upper lip misdiagnosed benign desmoplastic trichoepithelioma. Oral Maxillofac Surg. 2013;17:141–4.
Jedrych J, McNiff JM. Expression of p 75 neurotrophin receptor in desmoplastic trichoepithelioma, infiltrative basal cell carcinoma, and microcystic adnexal carcinoma. Am J Dermatopathol. 2013;35:308–15.
Sakanoue M, Matsushita S, Kawai K, Kanekura T. Microcystic adnexal carcinoma arising in a nevus sebaceous. Indian J Dermatol. 2013;58:247.
Boos MD, Elenitsas R, Seykora J, Lehrer MS, Miller CJ, Sobanko J. Benign subclinical syringomatous proliferations adjacent to a microcystic adnexal carcinoma: a tumor mimic with significant patient implications. Am J Dermatopathol. 2014;36:174–8.
Lai JH, Limacher JJ, Richards RN. Solid carcinoma revisited: a possible variant of microcystic adnexal carcinoma. Am J Dermatopathol. 2014;36:925–7.
Lopez M, Cole EL. Microcystic adnexal carcinoma: reconstruction of a large centrofacial defect. Plast Reconstr Surg Glob Open. 2014;2:e254.
Abenoza P, Ackerman AB. Neoplasms with eccrine differentiation. Philadelphia: Lea and Febiger; 1990. p. 394.
Suwattee P, McClelland MC, Huiras EE, Warshaw EM, Lee PK, Kaye VN, McCalmont TH, Niehans GA. Plaque-type syringoma: two cases misdiagnosed as microcystic adnexal carcinoma. J Cutan Pathol. 2008;35:570–4.
Wallace JS, Bond JS, Seidel GD, Samie FH. An important mimicker: plaque-type syringoma mistakenly diagnosed as microcystic adnexal carcinoma. Dermatol Surg. 2014;40:810–2.
Schaller J, Rytina E, Rütten A, Hendricks C, Ha T, Requena L. Sweat duct proliferation associated with aggregates of elastic tissue and atrophodermia vermiculata: a simulator of microcystic adnexal carcinoma. Report of two cases. J Cutan Pathol. 2010;37:1002–9.
Sellheyer K, Nelson P, Kutzner H, Patel RM. The immunohistochemical differential diagnosis of microcystic adnexal carcinoma, desmoplastic trichoepithelioma and morpheaform basal cell carcinoma using BerEP4 and stem cell markers. J Cutan Pathol. 2013;40:363–70.
Requena L, Kiryu H, Ackerman AB. Microcystic adnexal carcinoma. In: Neoplasms with apocrine differentiation. Philadelphia: Lippincott-Raven; 1998. p. 795–831.
Diamantis SA, Marks VJ. Mohs micrographic surgery in the treatment of microcystic adnexal carcinoma. Dermatol Clin. 2011;29:185–90.
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Requena, L., Sangüeza, O. (2017). Microcystic Adnexal Carcinoma. In: Cutaneous Adnexal Neoplasms. Springer, Cham. https://doi.org/10.1007/978-3-319-45704-8_26
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