Case Number : Case 2274 - 1 March 2019 Posted By: Dr. Richard Carr

Metastatic prostate ca vs primary adnexal ca

adenoid cystic carcinoma-perineural invasion seen [figure 8]-primary/?met

Cribriform carcinoma. My first thought is metastasic (Prostata or Salivary gland) and then, least likely (for me) Primary Adnexal Carcinoma.

Metastatic adenocarcinoma(prostate?)

My differential was between adenoid BCC and adenoid cystic carcinoma (latter favoured on H&E). Most of the "lumens" are stromal pseudolumens with stromal mucin. BerEP4 and EMA were limited to true ductal lumina and p63 showed a checker-board pattern typical of ACC (compared with diffuse staining in an adenoid BCC). I guess the p63 pattern would be incompatible with a metastatic adenocarcinoma (which I confess I had not considered). Well done K.S.

Thanks sir

Thanks Dr Carr, nice case. will also consider primary adnexal carcinoma with perineural invasion esp ACC, and metastatic adenocarcinoma. P63 is a must..