RESUMO
Primary cutaneous adenoid cystic carcinoma (PCACC) is a rare form of adenoid cystic carcinoma (ACC) arising commonly from the salivary gland. Less often they originate outside the head and neck region, with the scalp being the commonest cutaneous site in 40% of the cases. The presentation on the chest wall is rare, with no reports to date on axillary lymph node metastases. Here we report a case of a 65-year-old female with previously operated PCACC of the chest wall at a different center, showing uptake on positron emission tomography imaging at the site of surgical scar that w as inconclusive on needle biopsy metastasized to the axillary lymph node confirmed by needle biopsy managed with wide local excision, axillary lymph node dissection, and chest wall reconstruction with keystone island flap. The postoperative outcome was uneventful with no recurrence or axillary complications at one year's follow-up. She was advised to receive adjuvant radiotherapy; however, she refused. To conclude, though PCACC is rare, they can have an aggressive presentation, and a multidisciplinary approach is necessary for a better outcome.
Assuntos
Carcinoma Adenoide Cístico , Parede Torácica , Feminino , Humanos , Idoso , Parede Torácica/diagnóstico por imagem , Metástase Linfática , Carcinoma Adenoide Cístico/diagnóstico por imagem , Axila/patologia , Linfonodos/diagnóstico por imagemAssuntos
Adenocarcinoma/diagnóstico por imagem , Meato Acústico Externo/patologia , Neoplasias da Orelha/diagnóstico por imagem , Neoplasias das Glândulas Sudoríparas/diagnóstico por imagem , Adenocarcinoma/secundário , Adulto , Condroma/diagnóstico , Diagnóstico Diferencial , Meato Acústico Externo/diagnóstico por imagem , Neoplasias da Orelha/secundário , Feminino , Técnicas Histológicas , Humanos , Neoplasias das Glândulas Sudoríparas/patologia , Tomografia Computadorizada por Raios XRESUMO
A 41-year-old man from the state of Chhattisgarh, India, had a previous history of nasopharyngeal rhinosporidosis for 27 years, for which he had surgical intervention seven times, most recently endoscopically 2 months earlier. For the last 8 months, he had noticed skin lesions on the shoulders and forehead. Of interest was a history of bathing in ponds as a child. Examination revealed a soft, skin-colored, strawberry-shaped papule on the forehead (Figure 1A), a papule with a hemorrhagic crust on the left shoulder (Figure 1B), and a crusted friable plaque on the right shoulder (Figure 1C). Endoscopy revealed a 1 cm × 1 cm red polypoidal mass on the lateral wall of the nasopharynx. A diagnosis of disseminated cutaneous rhinosporidiosis with nasal-nasopharyngeal rhinosporidiosis was considered.
