Metastatic apocrine adenocarcinoma of the axillary area

Abstract

Background

Apocrine adenocarcinoma of the skin is a rare entity. It is characterized by slowly enlarging, painless, indurate nodules or plaques and often misdiagnosed as benign skin tumours. Although these tumours show characteristic tubular structures mixed with cellular cords and have some pattern of cytokeratins, primary apocrine carcinoma is indistinguishable from metastatic mammary ductal carcinomas. Like other apocrine carcinomas it is radioresistant and therefore surgical resection is the method of choice in treatment of patients. Distant metastases have been reported in a limited number of published cases.

Aim

We present the case of a 66-year-old woman with apocrine adenocarcinoma of the left axillary area with local lymph node and distant metastases.

Case Report

A 66-year-old woman was admitted to hospital because of a tumour located in the skin of the axillary area. After incision biopsy lobular breast carcinoma was initially suspected. Correlation of clinical, histological and immunohistochemical data allowed the rare apocrine adenocarcinoma to be diagnosed. The tumour was excised with axillary lymph nodes. Next chemotherapy was applied as palliative treatment.

Conclusions

Our observations lead us to following conclusions: (I) apocrine adenocarcinoma is a rare and difficult to diagnose tumour requiring special examination; (II) metastases to lung, liver and bones cause worse prognoses; (III) a wide surgical excision is the treatment of choice.