APOCRINE ADENOCARCINOMA PRESENTING AS A LARGE ULCERATED AXILLARY MASS

BACKGROUND. Apocrine adenocarcinomas ave one of the rarest cutaneous c ancers with few reported cases. Previously regarded nonspecifically as sweat gland tumors variants, they are now established as apocrine der ivatives. Most occur in the axilla. OBJECTIVE. To provide a gross and histological description of an apocrine adenocarcinoma presenting in a 49-year-old African-American man. METHODS. The mass was removed en bl oc with axillary lymph none dissection. The specimens were routinely e mbedded, and sectioned. Hematoxylin & eosin and periodic acid Schiff s taining was done. Ploidy evaluation was performed by cytometry. RESULT S. The mass was firm, nontender, and mobile (15 x 14 x 7 cm) with over lying areas of ulcerated skin. It was closely associated with the axil lary vessels, and latissimus dorsi and pectoralis major muscles, bur w as well circumscribed with extensive dystrophic calcification. Histolo gical examination revealed an adenocarcinoma with predominant apocrine features. The tumor was arranged in solid sheets and large glands in the reticular dermis and had a loose trabecular pattern extending to t he ulcerated skin surface. Two of seven local lymph nodes were positiv e for tumor; level two and three nodes were negative for tumor. DNA pl oidy study determined the tumor to be an aneuploid cell line with an 1 8% S-phase fraction. CONCLUSIONS. Tumor growth in this patient was rap id, histology unfavorable, and local nodes positive. However, aggressi ve surgical intervention resulted in 12 months follow-up without evide nce of recurrence. (C) 1997 by the American Society for Dermatologic S urgery, Inc.