Case Report
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Aug 6, 2022; 10(22): 8034-8039
Published online Aug 6, 2022. doi: 10.12998/wjcc.v10.i22.8034
Microcystic adnexal carcinoma misdiagnosed as a “recurrent epidermal cyst”: A case report
Si-Xuan Yang, Yan Mou, Shu Wang, Xin Hu, Fu-Qiu Li
Si-Xuan Yang, Yan Mou, Fu-Qiu Li, Department of Dermatology, The Second Hospital of Jilin University, Changchun 130000, Jilin Province, China
Shu Wang, Department of Radiotherapy, The Second Hospital of Jilin University, Changchun 130000, Jilin Province, China
Xin Hu, Department of Microbiology, Graduate School of Medicine, Kyoto University, Kyoto 606-8510, Japan
Author contributions: Yang SX performed research and wrote the paper; Mou Y, Wang S, Hu X; and Li FQ contributed critical revision of the manuscript for important intellectual content; all authors have read and approve the final manuscript.
Informed consent statement: Written informed consent has been obtained from the patient to publish this paper.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Fu-Qiu Li, Doctor, MD, PhD, Chief Doctor, Professor, Teacher, Department of Dermatology, The Second Hospital of Jilin University, No. 218 Ziqiang Street, Nanguan District, Changchun 130000, Jilin Province, China. lifuqiu1234@126.com
Received: February 28, 2022
Peer-review started: February 28, 2022
First decision: May 30, 2022
Revised: June 10, 2022
Accepted: June 24, 2022
Article in press: June 24, 2022
Published online: August 6, 2022
Processing time: 143 Days and 15.7 Hours
Abstract
BACKGROUND

Microcystic adnexal carcinoma (MAC) is a rare malignant cutaneous adnexal neoplasm, often presenting as a flesh-colored and slow-growing indurated plaque or cystic nodule in the mid-facial region. Its characteristic indolent presentation usually leads to initial misdiagnosis, resulting in tumor mismanagement and added morbidity due to increased propensity for local invasion.

CASE SUMMARY

A 63-year-old Chinese male patient with a long-term history of excessive ultraviolet irradiation had received two surgeries for an “epidermal cyst” on his glabella and was presented to our hospital’s Dermatology Department for further diagnosis and therapy of the lesion on his glabella. One month ago, his two 7 mm × 7 mm subcutaneous nodules were diagnosed as "recurrent epidermal cysts", and he underwent local excision surgery. Additionally, he has post medical history of surgery for right clear cell renal carcinoma. According to his biopsy, the patient was diagnosed as MAC in our hospital, and a tumor remnant was found on his wound. He then underwent wide local excision to achieve negative margins and reconstruction of full-thickness flap transplantation for tissue coverage. He remained tumor-free after six months of follow-up.

CONCLUSION

This case highlights the importance of MAC’s possible pathogenic factor of excessive ultraviolet exposure, its differential diagnosis to avoid misdiagnosis and mismanagement to adverse prognosis, the patient’s particular medical history of clear cell renal carcinoma, the alert for any tumor recurrence in older patients, and his uncommon multiple nodules mess consisting of two 7 mm × 7 mm subcutaneous nodules, that will enrich the existing knowledge of MAC’s clinical features.

Keywords: Microcystic adnexal carcinoma; Recurrent epidermal cyst; Differential diagnosis; Clear cell renal carcinoma; Excessive ultraviolet radiation; Case report

Core Tip: Microcystic adnexal carcinoma is an uncommon skin malignant tumor with a high misdiagnosis rate. We present a rare case of multiple nodules of microcystic adnexal carcinoma misdiagnosed as a “recurrent epidermal cyst.” The patient has a long-term history of excessive ultraviolet irradiation.