Primary cutaneous mucinous carcinoma: Presence of myoepithelial cells as a clue to the cutaneous origin

Hina S. Qureshi, Mohamed E. Salama, Dhannanjay Chitale, Ila Bansal, Chan K. Ma, Usha Raju, Adrian Ormsby, Min W. Lee

Research output: Contribution to journalArticle

49 Scopus citations

Abstract

Background: Primary cutaneous mucinous carcinoma (PCMC) is a rare malignancy with probable apocrine differentiation. It is important to differentiate it from metastatic mucinous carcinoma (MMC), especially from the breast. The histologic and immunohistochemical features overlap between PCMC and breast mucinous carcinomas. In this study, we introduce the presence of myoepithelial component in PCMC as a new morphologic parameter to distinguish it from MMC from either breast or sites elsewhere in the body. Materials and Methods: We studied 7 cases of PCMC. The possible in situ component in the tumor was assessed by the presence of a peripheral myoepithelial cell layer. Myoepithelial cell differentiation was confirmed with immunohistochemical stains for p63, CK 5/6, calponin, smooth muscle actin (SMA), HHF-35, and CD10. Estrogen and progesterone receptor (ER/PR), gross cystic disease fluid protein (GCDFP 15), CK7, CK20, and S-100 immunostains were also performed. Results: Histologically, multiple small monomorphic epithelial islands floating in multilocular pools of mucin characterized the tumor. Focally, epithelial islands were bordered by dermal connective tissue at the periphery of mucin pools. Secretory snouts were apparent in all cases providing evidence for apocrine differentiation. In 5 of the 7 cases, an in situ component was identified as epithelial islands being bounded by a myoepithelial layer, which was highlighted by p63, CK 5/6, calponin, SMA, and HHF-35. ER/PR and CK7 were positive in all the cases. GCDFP-15 and CD10 were focally positive in the tumor cells and myoepithelial cells, respectively. All 7 cases were negative for S-100 and CK 20. Conclusion: We conclude that an in situ component is frequently present in PCMC (5/7) and may help in distinguishing this entity from MMC, especially of breast origin. Furthermore, it may provide insight into the pathogenetic mechanism of mucinous carcinoma evolving from in situ carcinoma with luminal mucinous distention to cellular tumor with a little surrounding mucin.

Original languageEnglish (US)
Pages (from-to)353-358
Number of pages6
JournalAmerican Journal of Dermatopathology
Volume26
Issue number5
DOIs
StatePublished - Oct 1 2004

Keywords

  • Breast
  • Metastatic carcinoma
  • Mucinous carcinoma
  • Myoepithelium
  • Skin

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Dermatology

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