Mucinous carcinoma of the skin, primary, and secondary: A clinicopathologic study of 63 cases with emphasis on the morphologic spectrum of primary cutaneous forms: Homologies with mucinous lesions in the breast

Dmitry V. Kazakov, Saul Suster, Philip E. LeBoit, Eduardo Calonje, Michele Bisceglia, Heinz Kutzner, Arno Rütten, Thomas Mentzel, Jörg Schaller, Bernhard Zelger, Mehmet Baltaci, Ilmo Leivo, Christian Rose, Masaharu Fukunaga, Roderick H W Simpson, Yu Yang, J. Andrew Carlson, Alberto Cavazza, Ondrej Hes, Petr MukensnablTomas Vanecek, Ana Fidalgo, Karel Pizinger, Michal Michal

Research output: Contribution to journalArticle

Abstract

We present the largest series of mucinous carcinoma involving the skin, describing the histopathologic, immunohistochemical, electron microscopic, and cytogenetic findings. Our aim was fully to characterize the clinicopathologic spectrum and compare it with that seen in the breast. In addition, we wished to reevaluate the differential diagnostic criteria for distinguishing primary mucinous carcinomas from histologically similar neoplasms involving the skin secondarily, and study some aspects of their pathogenesis. We demonstrate that primary cutaneous mucinous carcinomas span a morphologic spectrum compatible to their mammary counterparts. Both pure and mixed types can be delineated morphologically, and some lesions have mucocele-like configurations. Most lesions seem to originate from in situ lesions that may represent, using mammary pathology terminology, ductal hyperplasia, atypical ductal hyperplasia, or ductal carcinoma in situ or a combination of the three. Inverse cell polarity appears to facilitate the progression of the changes similar to lesions in the breast. The presence of an in situ component defines the neoplasm as primary cutaneous, but its absence does not exclude the diagnosis; although for such neoplasms, full clinical assessment is essential. Mammary mucinous carcinoma involving the skin: all patients presented with lesions on chest wall, breast, axilla, and these locations can serve as clue to the breast origin. Microscopically, cutaneous lesions were of both pure and mixed type, and this correlated with the primary in the breast. Dirty necrosis was a constant histologic finding in intestine mucinous carcinomas involving the skin, and this feature may serve as a clue to an intestinal origin.

Original languageEnglish
Pages (from-to)764-782
Number of pages19
JournalAmerican Journal of Surgical Pathology
Volume29
Issue number6
DOIs
Publication statusPublished - Jun 2005

Keywords

  • Dirty necrosis
  • Gelatinous carcinoma
  • Globoid cells
  • HER-2/neu gene
  • In situ
  • Inverse cell polarity
  • Mucinous carcinoma
  • Mucocele-like tumors
  • Signet-ring cells

ASJC Scopus subject areas

  • Anatomy
  • Pathology and Forensic Medicine

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    Kazakov, D. V., Suster, S., LeBoit, P. E., Calonje, E., Bisceglia, M., Kutzner, H., Rütten, A., Mentzel, T., Schaller, J., Zelger, B., Baltaci, M., Leivo, I., Rose, C., Fukunaga, M., Simpson, R. H. W., Yang, Y., Carlson, J. A., Cavazza, A., Hes, O., ... Michal, M. (2005). Mucinous carcinoma of the skin, primary, and secondary: A clinicopathologic study of 63 cases with emphasis on the morphologic spectrum of primary cutaneous forms: Homologies with mucinous lesions in the breast. American Journal of Surgical Pathology, 29(6), 764-782. https://doi.org/10.1097/01.pas.0000159104.02985.6b