Adenocystic carcinoma of the sweat glands (syringocarcinoma): causes, symptoms, diagnosis, treatment

Adenokistozny cancer of sweat glands (syn: syringocarcinoma, hydrocarcinoma) - a very rare tumor of low grade (primary cancer of the sweat glands), occurs mainly in old age, usually on the skin of the face, the scalp, less often the trunk, abdominal wall.

It appears as a plaque or an intradermal node of a hemispherical shape, a pinkish color with insufficiently defined boundaries. With prolonged existence it can ulcerate and crust. The growth of the tumor is relatively slow, the sizes range from 1 to 8 cm. In some cases, the tumor can exist for years without metastasizing, but cases of rapid growth and metastasis of the tumor are described.

Pathomorphology of adenocystic cancer of sweat glands (syringocarcinomas). The tumor consists of cells that form solid, tubular and cribrous structures in various ratios. Usually, the tubular and cribriform components predominate in the dermis with the formation of pseudo-iron structures, in the lumens of which hyaluronic acid, eosinophilic globules and necrotic tumor cells are contained. The tubular component consists of duct structures surrounded by a basal membrane. When invading the underlying tissues, the tumor can acquire a scirrhous appearance. In electron microscopic examination, ductal structures lined with cells with pronounced nuclear atypia and the presence of secretory granules in the cytoplasm are revealed. In addition, there are structures that completely repeat the structure of the embryonic rudiment of the sweat gland. Cells of adenocystic carcinoma have rounded, hyperchromic nuclei and an indistinctly delimited cytoplasm. Along with the glycogen granules in the tumor cells, there are granules of neutral mucopolysaccharides, which are also found in the perulumaric cuticle. Some anaplastic elements may undergo squamous metaplasia. Quite often there is perineural invasion of tumor cells

In tumor cells, high activity of dehydrogenases of succinic, lactic, isomonic acids, monoamine oxidase and acid phosphatase, positive reaction with carcinoembryonic antigen, S-100 protein and epithelial membrane antigen was revealed.

Histogenesis of adenocystic cancer of sweat glands (syringocarcinomas). The histogenetic association of the tumor with the sweat glands is not questioned by anyone, the spores are conducted around the type of glands - ekrini or apocrine. P. Abenoza, A.V. Ackerman (1990) believe that there is no convincing evidence in favor of one of the two options.

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