Mucinous carcinoma: causes, symptoms, diagnosis, treatment

Mucinous carcinoma (syn. mucinous eccrine carcinoma) is a rare primary carcinoma of sweat glands of low malignancy grade. It occurs twice as often in men. According to P. Abenoza, AB Ackerman (1990), the average age of patients is 60 years, growth is slow - for years and even decades. Three quarters of tumors are localized on the scalp - periorbitally 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 appears as a solitary node 0.5-3 cm in diameter with a smooth surface, skin-colored or slightly bluish tint, dense-elastic consistency, occasionally ulcerated.

Pathomorphology of mucinous carcinoma. The node is located in the dermis and subcutaneous adipose tissue. Nested accumulations of tumor cells are located in "lakes" of mucin, separated by thin partitions. The degree of cellular atypia may vary. Infiltrate of inflammatory cells is practically absent. Tumor cells can form glandular and duct-like structures in the form of complexes of solid, cribriform, adenoid cystic and papillary types. Cells with apocrine type of secretion can be found along the periphery of nested accumulations. Tumor cells are oval, round or polygonal in shape with homogeneous, pinkish slightly vacuolated cytoplasm. The location of cells perineurally or in lymphatic vessels is usually not characteristic. Ultrastructural examination revealed peripheral "dark" cells and centrally located "light" cells among the cells forming nests. Dark cells contain bundles of tonofilaments, many secretory granules, and a rich Golgi apparatus in the cytoplasm. Signs of glandular differentiation are also noted. Mucin in mucinous carcinoma is rich in sialic acid, and this is one of the criteria for differentiation from adenoid cystic carcinoma, in which the mucous component contains hyaluronic acid.

Histogenesis of mucinous carcinoma. There is no consensus on the eccrine or apocrine genesis of the tumor. In practical terms, it is much more important to differentiate primary mucinous carcinoma of the skin from metastases to the skin of mucinous carcinomas of the mammary gland, gastrointestinal tract, lungs, ovaries, and pancreas.

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