Primary cutaneous apocrine gland carcinoma from areolar tissue in a male patient with gynecomastia: a case report
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CASE REPORT
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Primary cutaneous apocrine gland carcinoma from areolar tissue in a male patient with gynecomastia: a case report Kyung-Jin Seo1 and Jae-Jun Kim2*
Abstract Primary cutaneous apocrine gland carcinoma, which is a type of sweat gland carcinoma, is an extremely rare type of cancer. Clinical courses of this type of cancer usually progress slowly but can, occasionally, be associated with rapid progression. This case report describes a 53-year-old Korean man with primary cutaneous apocrine gland carcinoma that arose from an apocrine gland in the areola tissue. The patient visited our hospital because of a large, painful chest wall mass beneath the right nipple. The mass had been present for more than eight years but had grown rapidly over the past few months. The patient was initially diagnosed with a benign cystic mass, and we performed a wide excision with a clear margin and without lymph node dissection. The mass was a well-encapsulated cystic lesion that contained old blood material, and there was no invasion into the surrounding tissue. The final pathology showed that the mass was a primary cutaneous apocrine gland carcinoma that arose from the areola apocrine sweat gland, not from the breast parenchymal tissue. Herein, we report an extremely rare chest wall mass unfamiliar to thoracic surgeons.
Background Primary cutaneous apocrine gland carcinoma (PCAGC) is an extremely rare malignant tumor of a skin appendage [1–4]. It most commonly develops in the axilla but can develop in any locations containing apocrine sweat glands [1–4]. Herein, we report a case of ingrowing primary cutaneous apocrine gland carcinoma that arose from an apocrine gland in the areola of a male patient with gynecomastia. Case report A 53-year-old Korean man presented to our hospital with a painful, large, round chest wall mass beneath the right nipple measuring about 10 × 10 cm in size. The skin overlying the mass was reddish and hyperpigmented. The mass had been present for more than 8 years but had grown rapidly over the past few months. There were no palpable lymph nodes and no other breast masses on physical exams. A chest CT showed * Correspondence: [email protected] 2 Department of Thoracic and Cardiovascular Surgery, Uijeongbu St. Mary’s Hospital, The Catholic University of Korea College of Medicine, 271 Cheonbo Street, Uijeongbu, Gyeonggi-do 11765, South Korea Full list of author information is available at the end of the article
no remarkable lymph nodes and a 9.3 × 6.7 cm, welldefined, thin-walled, cystic mass with some nodular enhancing lesions in the lateral wall of the mass. This suggested a benign soft tissue mass, such as a large epidermal inclusion cyst (Fig. 1). Because we considered the mass to be a benign cystic mass, we excised it without lymph node dissection. We were able to save the nipple because the mass was limited to the subcutaneous layer beneath the areolar tissue. The mass was a well-encapsulated cystic lesion that contained old blood material, and there was no gross invasion into the s
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