PMC5030426_01
Clinical appearance: a 3.5 x 3.5 cm, dark-red, hemorrhagic, ulcerated tumor on the right side of the anterior labial commissure.
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Physical examination revealed a dark-red, hemorrhagic, ulcerated tumor on the right side of the anterior labial commissure measuring approximately 3.5 x 3.5 cm (Figure 1).
Morphologic findings (hematoxylin and eosin stain). (a) Tumor cells predominantly in the dermis with slight invasion into the subcutaneous tissue (magnification x5). (b) The tumor cells showed granular eosinophilic cytoplasm and oval-round nuclei with prominent nucleoli and were arranged in solid, trabecular, and glandular patterns (magnification x100). Partially decapitation-type secretion was seen (arrows). (c) The overlying epidermis was partially destroyed (magnification x10). (d) Pagetoid spread of neoplastic cells in the peripheral epidermis of the tumor (magnification x20).
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Histopathologic findings showed atypical tumor cells growing predominantly in the dermis with slight invasion into the subcutaneous tissue (Figure 2(a)). The atypical cells showed granular eosinophilic cytoplasm and oval-round nuclei with prominent nucleoli and were arranged in solid, trabecular, and glandular patterns, partially with decapitation-type secretion, indicating apocrine secretion (Figure 2(b)). The overlying epidermis was partially destroyed (Figure 2(c)). In the peripheral epidermis of the tumor, pagetoid spread of neoplastic cells was limitedly present (Figure 2(d)).
(a) Positive immunostaining for gross cystic disease fluid protein-15. (b) Positive immunostaining for androgen receptor.
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In immunohistochemical findings, the tumor cells were positive for pan-cytokeratin, cytokeratin 7, epithelial membrane antigen, gross cystic disease fluid protein-15 (Figure 3(a)), and androgen receptor (AR) (Figure 3(b)), confirming the apocrine origin of the tumor.