Primary cutaneous adenoid cystic carcinoma: a clinicopathologic and immunohistochemical study of 27 cases

Rathi Ramakrishnan, Iskander H Chaudhry, Pratistadevi Ramdial, Alexander J Lazar, Mairin E McMenamin, Dmitry Kazakov, Thomas Brenn, Eduardo Calonje

Research output: Contribution to journalArticlepeer-review

Abstract

AIMS: This study examines clinical and pathologic features of primary cutaneous adenoid cystic carcinoma (ACC), with emphasis on biological behavior of these tumors. A total of 27 cases of primary cutaneous ACC with detailed follow-up information were evaluated. Clinically, these were solitary, slow-growing lesions, half of which were in the head and neck area. The median age was 62 years with a male predilection. Surgical excision was the treatment of choice. Histologically, the lesions were similar to those seen in the salivary glands. Tumors were classified as grade 1 (17), grade 2 (3), and grade 3 (7). The mitotic count was generally low (mean=1.9/mm), except in 2 high-grade tumors (>10 mitotic figures/mm). Sixteen cases showed perineural invasion. Immunohistochemically, cytokeratin positivity was noted in 13/13 cases, and CD117 was observed in 10/10 cases, with luminal/cytoplasmic staining for epithelial membrane antigen (14/16) and at least focal luminal expression for carcinoembryonic antigen (11/16), smooth muscle actin (10/13), and S100 staining (9/13). Eighteen cases had follow-up data (median 54 mo), 9 of which had local recurrences (50%). Three cases showed metastatic disease. No statistical difference was noted between tumor grade and local recurrence (P=0.77). Primary cutaneous ACC is a distinct entity with a more indolent behavior compared with its salivary counterpart. The cutaneous lesions tend to recur locally but have a low metastatic potential.

Original languageEnglish
Pages (from-to)1603-11
Number of pages9
JournalAmerican Journal of Surgical Pathology
Volume37
Issue number10
DOIs
Publication statusPublished - Oct 2013

Keywords

  • Adult
  • Aged
  • Aged, 80 and over
  • Carcinoma, Adenoid Cystic
  • Female
  • Humans
  • Immunohistochemistry
  • Male
  • Middle Aged
  • Skin Neoplasms
  • Tumor Markers, Biological

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