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Apocrine hidradenocarcinoma showing Paget’s disease and mucinous metaplasia
Author(s) -
Wahl Carter E.,
Todd Douglas H.,
Binder Scott W.,
Cassarino David S.
Publication year - 2009
Publication title -
journal of cutaneous pathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 75
eISSN - 1600-0560
pISSN - 0303-6987
DOI - 10.1111/j.1600-0560.2008.01079.x
Subject(s) - pathology , mucinous carcinoma , apocrine , eosinophilic , cytokeratin , metaplasia , atypia , medicine , nuclear atypia , lesion , adenocarcinoma , immunohistochemistry , cancer
A 54‐year‐old man presented with a solitary, erythematous, rapidly growing 1‐cm nodule on his scalp that had arisen over the previous 3 months. He had no history of skin cancer. An excisional biopsy of the lesion showed a fairly well‐circumscribed but focally invasive tumor consisting of areas of typical‐appearing clear cell hidradenoma as well as areas with mucinous goblet‐type cells and cells with eosinophilic cytoplasm and decapitation‐type secretion. There was marked cellular atypia, numerous atypical mitotic figures and focal necrosis. The tumor cells focally involved the overlying epidermis (Paget’s disease). Large areas of mucin were identified throughout the lesion. The tumor cells stained with markers for cytokeratin 7 and focally for EMA and CEA, confirming ductal differentiation. The goblet cells and mucinous areas stained with mucicarmine and PASD. The patient was diagnosed with hidradenocarcinoma with mucinous differentiation. Associated Paget’s disease has only rarely been reported, and mucinous metaplasia is a previously unreported feature in hidradenocarcinoma.