Case Number : 103 Posted By: Guest

Nagla ramdan - Zagazig University (Egypt) Wrote:

I agree with adenoid cystic carcinoma

Submitted on 23/11/2010 15:07

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Nagla ramdan - Zagazig University (Egypt) Wrote:

I agree with adenoid cystic carcinoma

Submitted on 23/11/2010 15:07

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Maria claudia - FEDERICO LLERAS (BOGOTÁ) Wrote:

CARCINOMA ADENOIDE QUISTICO

Submitted on 10/11/2010 00:27

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Phillip McKee - Overseas consultations (Sedona, Arizona, USA) Wrote:

Everyone has done very well. The diagnosis is primary cutaneous adenoid cystic carcinoma. It is worth remembering that basement membrane deposition is often focal particularly in cutaneous examples. Obviously metastatic disease and direct extension from an underlying tumor for example from the salivary gland would have to be excluded. Unfortunately, Richard you have posed so many issues that I do not have time to address them. The only point I would make is that for me, eccrine ductal carcinoma looks identical to breast ductal carcinoma and therefore it wouldn't enter the differential diagnosis. Adenoid BCC is an obvious important differential and often is it difficult to make the distinction. Careful searching for an epidermal origin, retraction artifact and stromal mucin deposition in addition for special stains and immunohistochemistry will solve the problem in the majority of cases. The mucin in thie example was D-PAS and alcian blue positive.

Submitted on 01/11/2010 20:28

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Richard Carr - Warwick (UK) Wrote:

I found this very difficult but my thoughts are looks a bit too high grade for the cutaneous adenoid cystic carcinomas I have seen and lacks the myoepithelial cell component or basement membrane in this field. I wondered about a higher grade eccrine ductal carcinoma that just happens to be cribriform, BCC with adenoid pattern, basaloid SCC of the anal canal can have a pseudoadenoid pattern, a metastasis from a cribriform carcinoma elsewhere (e.g. breast, salivary gland). Nice case, can't wait to find out. Note: p63 would be diffuse in BCC and basaloid SCC and zonal in cutaneous adenoid cystic carcinoma. I guess in breast cancer or anohter visceral adenocarcinoma p63 and CK5 would usually be negative. Regards to all.

Submitted on 01/11/2010 19:43

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Marcela Saeb Lima - Instituto Nacional de Ciencia Médicas y Nutrición Salvador Zubirán (Mexico City) Wrote:

Adenoid cystic carcinoma.

Submitted on 01/11/2010 15:38

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Sasi Attili - Ninewells University Hospital (Dundee, UK) Wrote:

Adenoid Cystic Carcinoma but imp to r/o metastatic disease

Submitted on 01/11/2010 14:16

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Marwa Fawzi - Dermatology Department, Faculty of Medicine, Cairo University (Egypt) Wrote:

Adenoid cystic carcinoma

Submitted on 01/11/2010 12:32

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Mona Abdel-Halim - Dermatology Department, Faculty of Medicine, Cairo University (Egypt) Wrote:

Primary cutaneous adenoid cystic carcinoma of the skin is rare, regarded in the past as eccrine tumors but said to be now of apocrine origin. May also arise primarily from the bartholin glands in the vulva or from the ceruminous glands in the external ear canal. On the other hand, ACC is a well known salivary gland tumor. So this case could be a rare primary cutaneous ACC or an extension or metastasis from a salivary gland tumor.

Submitted on 01/11/2010 11:10

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ANDREW DANCKWERTS - WITS UNIVERSITY, JOHANNESBURG (JOHANNESBURG, RSA) Wrote:

ISLANDS OF PERIPHERALLY PALISADED BASALOID CELLS WITH PUNCHED-OUT CRIBIFORM SPACES, FILLED WITH MUCIN. NO BASEMENT MEMBRANE-LIKE MATERIAL NOTED. Dx: ADENOID CYSTIC CARCINOMA; HOWEVER, A VARIANT OF BASAL CELL CCARCINOMA (BCC), SUCH AS ADENOID BCC CANNOT BE EXCLUDED. FURTHERMORE, THE POSSIBILITY OF A METASTATIC SALIVARY GLAND TUMOUR MAY ALSO BE CONSIDERED.

Submitted on 01/11/2010 10:32

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Graham Reilly - Princess Elizabeth Hospital (Guernsey) Wrote:

Collections of cells arranged in a cribriform pattern with mucin filled cystic spaces. I agree with above - Adenoid cystic carcinoma.

Submitted on 01/11/2010 10:01

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Mona Abdel-Halim - Dermatology Department, Faculty of Medicine, Cairo University (Egypt) Wrote:

Islands of basaloid cells showing crebriform and tubular areas. My diagnosis is Adenoid cystic carcinoma