Case Number : Case 1612 - 30 August Posted By: Guest

Agree with a primary tumor of the skin, thinking of Low grade mucoepidermoid carcinoma of the skin.

Primary cutaneous mucoepidermoid carcinoma Chun W. Ng1, Richie C. Chan2, Ronnie S. Ho3, Jimmy Y. Chan4 

My impression is as you guys mentioned that this is not a metastatic tumor but a primary one. Based on topography I cannot rule out cutaneous extension of a primary salivary gland neoplasm or more rarely a primary ceruminous gland neoplasm with compromise of the masthoideal region. Clinical information is extremely important in a case like this (compromise of the parotid gland? Hearing loss? External ear canal compromise?). Carcinoma ex pleomorphic adenoma could make an image like this one, also thought of high grade MEC, I would consider making more immunos like PLAG1 in this case and eventually molecular before making a diagnosis of primary sweat gland carcinoma

Primary cutaneous apocrine carcinoma. Imaging studies showed that the tumor is relatively superficial, making direct extension from other structures such as the parotid gland unlikely. No involvement of ear canal or hearing loss. For low grade mucoepidermoid carcinoma, should see so called mucous cells, which are lacking in this case. Areas of typical PA were not present, and PLAG1 and HMGA2 were both negative. Great suggestions everyone! A difficult case.