Apocrine carcinoma of the scalp – A case report and highlights for diagnosis

Abstract

Apocrine sweat gland carcinoma is a rare cutaneous adnexal neoplasm that may occur in the scalp, eyelid, and ear canal. More often, it presents as an asymptomatic, slow-growing, solid or cystic mass with variable color. The clinical appearance may be confused with basal cell carcinoma and the pathologic appearance with metastatic breast carcinoma. Supportive morphologic and immunohistochemical findings, together with careful clinicopathologic correlation, aid in diagnosis. The mainstay of treatment is wide local excision and neck dissection for node positive disease. The role of elective neck dissection and adjuvant radiotherapy remain controversial. Chemotherapy has been used for palliation in disseminated disease. This case report offers an algorithm that can aid the clinician in differential diagnosis of this often elusive neoplasm.