Mucinous carcinoma: causes, symptoms, diagnosis, treatment
Last reviewed: 23.04.2024
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Mucinous carcinoma (synicidal mucinous ecrcine carcinoma) is a rare primary carcinoma of sweat glands of low degree of malignancy. Occurs 2 times more often in men. According to P. Abenoza, AB Ackerman (1990), the average age of patients is 60 years, the growth is slow - for years and even decades. Three quarters of tumors are located on the scalp - periorbital 45%, on the scalp - 16%, on the cheeks - 8%. The second most frequent localization is the skin of the axillary regions (15%). Usually, the tumor manifests itself as a solitary knot with a diameter of 0.5-3 cm with a smooth surface, skin color or slightly bluish tinge, a tight-elastic consistency, and occasionally ulcerates.
Pathomorphology of mucinous carcinoma. The node is located in the dermis and subcutaneous adipose tissue. Nest clusters of tumor cells are located in the "lakes" of mucin, separated by thin septa. The degree of cellular atypia can be different. Infiltrate from inflammatory cells is practically absent. Tumor cells can form glandular and protozoan structures in the form of complexes of solid, creeping, adenocystic and papillary type. On the periphery of the nesting clusters, cells with apocrine type of secretion can be found. Tumor cells are oval, round or polygonal with a homogeneous, pinkish slightly vacuolized cytoplasm. The arrangement of cells perineurally or in lymphatic vessels, as a rule, is not typical. In the ultrastructural study among the cells forming the nests, peripheral "dark" cells and centrally located "light" cells were revealed. Dark cells contain in the cytoplasm bunches of tonofilament, a lot of secretory granules, a rich Golgi apparatus. There are also signs of glandular differentiation. Mucin in mucinous carcinoma is rich in sialic acid, and this is one of the criteria for differentiation with adenocystic carcinoma, in which the mucous component contains hyaluronic acid.
Histogenesis of mucinous carcinoma. There is no common opinion about the extrinsic or apocrine genesis of the tumor. In practical terms, it is much more important to differentiate the primary mucinous carcinoma of the skin from metastases into the skin of mucinous carcinomas of the breast, gastrointestinal tract, lungs, ovaries, pancreas.
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