PCMC is more frequently found in males and it usually appears between the ages of 50 hpv inside eyelid Mendoza and Hedwig hpv inside eyelid the first contemporary description of this eyelid-located tumour.
Taking into consideration the rarity of this tumour, a diagnosis of certitude is difficult to establish until further investigations are made, in order to eliminate the primary malignant tumour with visceral location with mucine production that can metastasize at cutaneous level, as for example that of breast, gastrointestinal tract, lung, kidney, ovary, pancreas, or prostate.
Hpv inside eyelid metastatic lesions that originate from the breast or colon hpv inside eyelid prone to mimic the cutaneous mucinous carcinoma 4. There is no specific clinical evidence virus oxiuros this type of tumour, as its appearance varies from one patient to another. The first clinical impression is that of a cyst, basal cell carcinoma, keratoacantoma, nevus, apocrine hidrocystoma, another location primary tumour metastasis and in certain circumstances the clinical differentiation includes vascular lesions as those found in the Kaposi sarcoma 5.
The patients describe a slow evolution, stretched over several years, of the lesion, completely asymptomatic. Occasional, the very old tumours or the very aggressive ones can invade the adjacent structures 6.
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The slow, benign evolution theory of this tumour is correlated with mucine production which is linked to its high celular differentiation grade. Moreover, the presence of big mucus accumulations can serve as physical barrier in tumour extension, compressing the tumour stroma, slowing the growth, inhibiting the DNA synthesis and hpv inside eyelid the angiogenesis rate 8.
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Although the clinical presentation of PCMC is non-specific, the histopathological exam is pathognomonic. Usually, the tumour is well delimitated, with small accumulations or tubules of epithelial cells which float in mucine.
Mucine is separated by fine collagen fibres septa and is positive to PAS stain, mucicarmina, alcian blue at a pH of 2. Mucine, same as sialomucine, was characterized as sialidase-labile.
The cells are small, basaloid, vacuolated with eosinophilic cytoplasm. The cellular pleomorfism and the 1.
Primary mucinous carcinoma, J Dermatolog Surg Oncol Primary mucinous carcinoma of the skin with metastases to hpv inside eyelid lymph nodes.
Am J Dermatopathol ; Carcinomas of sweat glands, report of 60 cases. Arch Pathol Lab Med ; Smith CC Metastazing carcinoma of the sweat-glands. Br J Surg43 Primary mucinous carcinoma of the skin: A population based study. Int J Dermatol. Further investigations are necessary in order to eliminate the skin metastasis 7,8.
The immunohistochemistry exam can facilitate the differential diagnoisis. PCMC cells remain positive for CK 7 and negative for CK 20, the same occurs for the mucinous adenocarcinoma of the breast, but in the case of the mucinous colorectal adenocarcinoma CK 7 is negative and CK 20 is positive. This hpv inside eyelid inside eyelid, the absence of CK 20 excludes skin metastases originated from the mucinous colorectal adenocarcinoma.
Another CK 7 positive and CK 20 negative tumours, as the hpv inside eyelid of the lung or of the gallbladder, can also produce skin metastases.
These can be excluded using systemic suplimentary investigations and another types of immunohistochemistry specific colorations 9. Because the skin metastases originating from breast and lung can express the p63 protein, the use of this expression remains controversial and so, further investigations are mandatory.
Quereshi et al.
In a complex analysis of the skin metastasis, Brownstein et al. The treatment of PCMC imposes local surgical excision.
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Because of the high local relapse rate, the proper excision with oncological safety margins at least 1 cm is recommended. The patients are informed that the periodical check-ups are of great importance regarding the local recurrence or the appearance of locoregional lymphadenopathy.
Conclusions PCMC is a rare malignant tumour that must be evaluated and treated correctly. The certainty of diagnosis is achieved by histopathological exam, specific investigations for excluding a metastasis, followed by surgical treatment with oncologic safety margins.
For the case report presented, we must underline that the local clinical exam was unspecific; the location of the tumour was extremely rare, with local invasion in sternal distal region, the anterior abdominal wall, peritoneum and mediastinum, since the diagnosis needed suplimentary investigations in order to establish the primary cutaneous mucinous adenocarcinoma.
Mucinous carcinoma of the skin, J Am Acad Dermatol ; Bone marrow relapse in primary mucinous carcinoma of the skin. Am J Clin Oncol ; Report of a case: primary mucinous carcinoma hpv inside eyelid hpv inside eyelid skin, Dermatol On J, 14 6 Primary mucinous carcinoma of the eyelid, a clinicopathologic and immunohistochemical study of 4 cases and an update on recurrence rates; Arch Ophthalmol ; 9 Although belived to be uncommon and despite campaigns that advocate safe sun exposure habbits and early consult for suspicious lesions, the annual incidence is in continuous rise.
Surgery is the best treatment for early stage disease, medical therapy being reserved for adjuvant situations and for unresectable and metastatic melanoma.
Chemotherapy offers poor response rates.