A case of axilla apocrine cancer.

A 52-year-old woman was admitted to our hospital in February 1991 with an intracutaneous tumor on the left axilla which was noticed as a small mass at the age of 20 and began to enlarge for the last 4 months.On admission, the tumor was firm, approximately 2.4cm in diameter, purplish red and showed radial folds on the surface.Histologically, the tumor was located in the dermis and subcutaneous tissue. The overlying epidermis was papillomatous. Numerous degenerated elastic fibers were seen in the upper and middle dermis.The tumor cells with eosinophilic cytoplasm tended to form tubular structures. Tubular luminal cells often showed decapitation secretion in the central part of the tumor.In the peripheral portion, the cells were atypical in part and showed invasive proliferation to the adjascent, along with vascular and nerve tissues. Transitional form of cells were seen between cetral and peripheral part of the tumor. A few apocrine glands were found in the stroma.Immunohistochemical studies revealed that all tumor cells were positive for EMA and keratin, negative for S-100 protein but CEA was pratially reactive in the periph-eral portion. Electron-microscopic study revealed apocrine and merocrine secretion.Widespread radical excision was performed and lymph node metastasis was found. There was no recurrence or metastasis at follow-up 16 months later.The tumor was diagnosed as apocrine carcinoma arising from axillary apocrine apparatus, however a possible diagnosis of carcinoma derived from accessory mamma remained to be ascertained.