Primary Cutaneous Mucinous Carcinoma

 Mucinous breast carcinoma


image Mucinous colonic carcinoma


• Other primary cutaneous tumors with mucin
image Basal cell carcinoma

image Adenoid cystic carcinoma



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Low Magnification of Primary Cutaneous Mucinous Carcinoma
Low-power view of primary cutaneous mucinous carcinoma (PCMC) shows islands of epithelial cells image floating in pools of mucin image. Fibrous septa image are present between some of the epithelial islands.


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Intermediate Magnification of Primary Cutaneous Mucinous Carcinoma
Medium-power view of PCMC shows islands of epithelial cells image in pools of mucin. Fibrous septa image, which characteristically divide the tumor into compartments, are present.

image
High Magnification of Primary Cutaneous Mucinous Carcinoma
Higher magnification shows uniform cells with hyperchromatic nuclei and eosinophilic cytoplasm. An occasional mitotic figure is identified image, but necrosis and marked cytologic atypia are not present.

image
ER Immunohistochemistry in Primary Cutaneous Mucinous Carcinoma
ER shows strong and diffuse nuclear staining in almost 100% of the tumor cells. This is a useful finding in excluding a metastatic mucinous colonic carcinoma, but it is not useful in excluding a metastatic breast carcinoma.


TERMINOLOGY


Abbreviations




• Primary cutaneous mucinous carcinoma (PCMC)


Synonyms




• Mucinous carcinoma, mucinous eccrine carcinoma, endocrine mucin producing carcinoma


Definitions




• Malignant cutaneous tumor with classic histology of epithelial islands “floating” in pools of mucin


CLINICAL ISSUES


Epidemiology




• Sex
image Men affected more often than women


Presentation




• Very rare tumor

• Occurs in adults and elderly

• Commonly on face, especially on eyelids

• Slow-growing, asymptomatic, solitary reddish papule, nodule, or cyst


Treatment




• Surgical approaches
image Wide local excision, ± dissection of regional lymph nodes

image Mohs micrographic surgery

image Antiestrogen drugs have been tried for patients with ER-positive tumors

image Chemotherapy and radiation have not been helpful in recurrent tumors


Prognosis




• Up to 36% local recurrence and up to 15% metastasis to regional lymph nodes or distant metastasis


MACROSCOPIC


Size




• 0.5-7 cm; rare larger lesions


MICROSCOPIC


Histologic Features




• Highly distinct low-power histologic appearance
image Composed of epithelial cells in nests and cords present in large pools of mucin

• Well-circumscribed, dermal-based tumor with occasional extension into subcutaneous tissues

• Occasional overlying ulceration

• Strands of fibrous tissue divide tumor into different compartments

Apr 24, 2017 | Posted by in PATHOLOGY & LABORATORY MEDICINE | Comments Off on Primary Cutaneous Mucinous Carcinoma

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