A Case of Primary Cutaneous Adenoid Cystic Carcinoma on the Axilla Showing Multiple Lung Metastasis

Abstract

Abstract : A 71-year-old woman noticed a cutaneous tumor on her right axilla about 30 years before the first visit, and underwent tumor resection performed by her local doctor 12 years previously. Although the tumor recurred a year later, she received no additional treatment. Chest computed tomography was performed for cough, which showed multiple nodules in her bilateral lungs. Histological examination of a biopsy specimen from the cutaneous tumor on the axilla revealed adenoid cystic carcinoma. Thus, she was referred to our hospital. On her first visit, she presented with a red tumor measuring 45×30 mm on her right axilla. We diagnosed her with primary cutaneous adenoid cystic carcinoma with local recurrence and metastasis of not only lymph nodes but also bilateral lungs. We performed surgical resection of the cutaneous tumor as palliative care and treated the lung metastasis with docetaxel for 1 year. Afterward, due to the development of a serious urinary tract infection and the gradual expansion of lung metastasis despite chemotherapy,docetaxel treatment was ceased, and only follow-up observation was performed without additional treatment. She died of adenoid cystic carcinoma 5 years after the first visit. Primary cutaneous adenoid cystic carcinoma is a relatively rare disease and has a better prognosis than adenoid cystic carcinoma arising from salivary gland. However, previous studies reported primary cutaneous adenoid cystic carcinomas with local recurrence and distant metastasis similar to our case. Local recurrence and distant metastasis sometimes develop after more than 5 years. Thus, we should treat primary cutaneous adenoid cystic carcinoma with resection with enough surgical margin and careful observation for a long period. Skin Research, 21 : 39-45, 2022