Adenocystic sweat gland cancer (syringocarcinoma): causes, symptoms, diagnosis, treatment

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

It appears as a plaque or intradermal node of a hemispherical shape, pinkish in color with insufficiently clear borders. With a long existence, it can ulcerate and become covered with a crust. The tumor grows relatively slowly, the size fluctuates 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 have been described.

Pathomorphology of adenoid cystic sweat gland cancer (syringocarcinoma). The tumor consists of cells that form solid, tubular, and cribriform structures in varying proportions. Typically, the dermis is dominated by tubular and cribriform components with the formation of pseudoglandular structures, the lumens of which contain hyaluronic acid, eosinophilic globules, and necrotic tumor cells. The tubular component consists of ductal structures surrounded by a basal membrane. When invading underlying tissues, the tumor may acquire a scirrhous appearance. Electron microscopic examination reveals ductal structures lined with cells with pronounced nuclear atypia and the presence of secretory granules in the cytoplasm. In addition, there are structures that completely repeat the structure of the embryonic rudiment of the sweat gland. Adenocystic carcinoma cells have round, hyperchromatic nuclei and poorly delineated cytoplasm. Along with glycogen granules, tumor cells contain granules of neutral mucopolysaccharides, which are also found in the periluminal cuticle. Some anaplastic elements may undergo squamous cell metaplasia. Perineural invasion of tumor cells is quite common.

In the tumor cells, high activity of succinic, lactic, isocitric acid dehydrogenases, monoamine oxidase and acid phosphatase, a positive reaction with carcinoembryonic antigen, S-100 protein and epithelial membrane antigen were detected.

Histogenesis of adenoid cystic cancer of sweat glands (syringocarcinoma). The histogenetic connection of the tumor with sweat glands is not questioned by anyone, the disputes are about the type of glands - eccrine or apocrine. P. Abenoza, A.B. Ackerman (1990) believe that convincing evidence in favor of one of the two options is still absent.

[ 1 ]