Author Affiliations: Departments of Dermatology (Dr Secrest, Ferris, and Sam), Epidemiology (Dr Secrest), and Pathology (Dr Seethala), University of Pittsburgh, Pittsburgh, Pennsylvania.
A 36-year-old previously healthy white man presented with an erythematous plaque on his right face and neck (Figure 1). Mistaken for cervicofacial cellulitis 15 months earlier, he was treated with systemic antibiotics and steroids for 3 months and was subsequently lost to follow-up.
A biopsy specimen of lesional skin was taken from the posterior neck. There was a poorly differentiated tumor infiltrating the deep reticular dermis with extensive lymphangitic spread (Figure 2A). On higher magnification, the proliferation could be seen to consist of large cells exhibiting abundant granular, eosinophilic cytoplasm, decapitation secretion, round pleomorphic nuclei with prominent nucleoli, and tubular formation with luminal secretions. Immunostaining was positive for androgen receptor and gross cystic disease fluid protein 15 (GCDFP-15) (Figure 2B-D) but not for p63, collagen IV, or laminin.
Secrest AM, Seethala RR, Ferris LK, Sam H. Cutaneous Apocrine Carcinoma Masquerading as Head and Neck Cellulitis: An Ominous Sign. Arch Dermatol. 2011;147(11):1335-1337. doi:10.1001/archdermatol.2011.349