Low-grade cylindromatous adnexal carcinoma with unusual histopathological features: report of a case with comparative immunohistochemical study and meta-analysis of the literature.
We present an extremely rare case of low-grade cylindromatous adnexal carcinoma (CAC) on the right chest wall of a 77-year-old man. Histopathologically, the neoplasm was initially diagnosed as a cylindroma that developed over the course of 13 years. A diagnosis of low-grade CAC was rendered after the documentation of a local recurrence and histopathology of the recurrent tumor. To further assess the evolution of low-grade CAC over time, we compared the morphology, mitotic account, proliferative markers and adhesion molecule immunoreactivity among paired primary and recurrent tumors. Unlike those earlier reported, our case showed the maintenance of tumor morphology after a recurrence without areas of obvious malignant transformation or metaplastic change. We showed here for the first time the expression of adhesion molecules of CAC/spiradenoma and a comparison of proliferation indices between a primary tumor and its local recurrence. This peculiar tumor differs from previously reported cases and harbors a malignant potential although the histopathological features of malignancy are subtle. Our meta-analysis of the literature provided background information regarding this rare entity. Alterations of E-cadherin and GCDFP-15 expression may provide additional helpful clues in differential diagnosis and determining the clinical behavior of this unusual neoplasm. Further studies are warranted to confirm the potential discriminative role of these markers.
Department of Diagnostic Pathology, Faculty of Medicine, Kagawa University, Kagawa, Japan.
Toshitetsu
T
Hayashi
Department of Diagnostic Pathology, Faculty of Medicine, Kagawa University, Kagawa, Japan.
Reiji
R
Haba
Department of Diagnostic Pathology, Faculty of Medicine, Kagawa University, Kagawa, Japan.
Naomi
N
Katsuki
Department of Diagnostic Pathology, Faculty of Medicine, Kagawa University, Kagawa, Japan.
Yoshio
Y
Kushida
Department of Diagnostic Pathology, Faculty of Medicine, Kagawa University, Kagawa, Japan.
Kyuichi
K
Kadota
Department of Diagnostic Pathology, Faculty of Medicine, Kagawa University, Kagawa, Japan.
Kenji
K
Bando
Department of Dermatology, Faculty of Medicine, Kagawa University, Kagawa, Japan.
Junko
J
Moriue
Department of Dermatology, Faculty of Medicine, Kagawa University, Kagawa, Japan.
Ikumi
I
Yokoi
Department of Diagnostic Pathology and Medical Education, Tokyo Medical University, Tokyo, Japan.
Miki
M
Izumi
Department of Dermatology, Faculty of Medicine, Kagawa University, Kagawa, Japan.
Yasuo
Y
Kubota
E-cadherin; GCDFP-15; immunohistochemistry; low-grade cylindromatous adnexal carcinoma; meta-analysis