Mixed Skin and Ecrino Component Cutaneous Carcinoma: Literature Review and Clinical Case Presentation

Abstract

Introduction: Tumors of the skin adnexal are lesions that arise from, or differ towards, structures in normal skin, such as regions of hair follicles, ducts, sweat glands, sebaceous glands, or a combination of these elements. Corresponding to 0.0005% of all malignant neoplasms of the skin. The present work aims to review the literature on skin adnexal carcinomas, their behavior and management, as well as to present a clinical case from the head and neck surgery service of a female patient with skin adnexal carcinoma.

Methods: The search was in the PubMed and Cochrane Library databases, the key words were: trichilemmal carcinoma of skin adnexal and eccrine carcinoma of skin adnexal, a descriptive review was made. The patient was a 31-year-old female, evaluated in April 2021, with a nodular lesion involving the nasal vestibule, columella and jugal mucosa of the upper lip, with 1 year of evolution, with a biopsy that reported: basal cell carcinoma.

Results: 11 publications were identified. A descriptive review of the anatomical and epidemiological aspects, clinical findings and treatment was carried out. The patient deserved micrographic oncological resection with immediate reconstruction, whose definitive biopsy reported: Neoplastic lesion of skin attachments with an infiltrative pattern, consisting of covering the outer layer of the hair root and exhibiting pillar keratinization. Immunohistochemistry reported CEA: weak cytoplasmic positivity in tumor areas with a ductal appearance. The definitive report suggested: Adnexal microcystic carcinoma.

Conclusions: Investigations of skin adnexal tumors such as trichilemmal carcinoma and eccrine carcinomas are rare, the behavior and prognosis are difficult to predict. Its diagnosis must be supported by biopsy and immunohistochemistry. Mohs surgery or margin- free surgery is ideal to achieve tumor-free margins.