ABSTRACT
PURPOSE: To find immunohistochemical markers that distinguish adenocarcinoma of the nonpigmented ciliary epithelium (NPCE) from metastatic carcinoma, especially metastatic renal cell carcinoma. DESIGN: Retrospective case series. METHODS: Three cases of adenocarcinoma of the NPCE were examined histologically with hematoxylin-eosin stain and immunohistochemical stains including vimentin, AE1/AE3, Cam 5.2, CK7, PAX2, PAX8, AMACR, and CAIX. We also reviewed previously reported cases of this tumor. RESULTS: We found that the immunohistochemical profile of adenocarcinoma of the NPCE can overlap with renal cell carcinoma. Both tumors can express vimentin, cytokeratin AE1/AE3, Cam 5.2, PAX2, PAX8, and AMACR. One of the adenocarcinomas of the NPCE in our series also expressed CD10 and the renal cell carcinoma marker (RCC Ma). Carbonic anhydrase IX (CAIX) was not detected in any of the 3 tumors. CONCLUSIONS: Adenocarcinomas arising in phthisic eyes can be diagnostically challenging. We have found it particularly difficult to distinguish adenocarcinoma of the NPCE from metastatic carcinoma, especially metastatic clear cell renal cell carcinoma and papillary renal cell carcinoma. Because of the immunophenotypic overlap, most patients will require systemic workup including imaging of the kidneys to be certain of the diagnosis.
Subject(s)
Adenocarcinoma/diagnosis , Biomarkers, Tumor/metabolism , Carcinoma, Renal Cell/diagnosis , Ciliary Body/pathology , Kidney Neoplasms/diagnosis , Neoplasm Proteins/metabolism , Uveal Neoplasms/diagnosis , Adenocarcinoma/metabolism , Adult , Aged , Carcinoma, Renal Cell/metabolism , Ciliary Body/metabolism , Female , Humans , Immunohistochemistry , Kidney Neoplasms/metabolism , Male , Middle Aged , Pigment Epithelium of Eye/metabolism , Pigment Epithelium of Eye/pathology , Retrospective Studies , Uveal Neoplasms/metabolismABSTRACT
Syringomatous adenoma of the nipple (SAN) is a rare benign lesion which often presents as a subareolar mass with associated nipple shape changes including pruritus, crusting, and discharge It is thought that syringomatous tumors arise from eccrine glands of the nipple and areola. Due to its locally infiltrative growth pattern the main differential is with low-grade adenosquamous carcinoma which requires more aggressive surgical treatment. Syringomatous adenoma of the nipple can recur, and therefore complete local excision is recommended. We present a case of a syringomatous adenoma of the nipple diagnosed after nearly 5 years of observation with microcalcifications noted on mammography.
