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Case Report
Apocrine adenocarcinoma in a patient with a partner and localizer of BRCA2 (PALB2) genetic mutation: A case report
1 College of Osteopathic Medicine, William Carey University, Hattiesburg, MS, USA
2 Family Medicine, Singing River Health System, Biloxi, MS, USA
Address correspondence to:
Anna Breland
36001 Sibley Lane, Stapleton, AL 36578,
USA
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Article ID: 100149Z10AB2025
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Breland A, Cooper T. Apocrine adenocarcinoma in a patient with a partner and localizer of BRCA2 (PALB2) genetic mutation: A case report. J Case Rep Images Oncology 2025;11(2):11–15.ABSTRACT
Introduction: Apocrine adenocarcinoma is a rare malignant neoplasm involving apocrine sweat glands. Physical presentation is variable, as masses can be violaceous, erythematous, solid, cystic, nodular, or ulcerated. Due to its lack of distinctive physical features, immunohistochemical staining with clinical correlation is imperative to reach an accurate diagnosis.
Case Report: A 72-year-old male presented with a painful, erythematous mass in the right axilla. A shave biopsy with immunohistochemical staining revealed estrogen receptor (ER) negative, progesterone receptor (PR) negative, human epidermal growth factor receptor 2 (HER2) negative results, suggesting ductal carcinoma of breast origin. However, follow-up imaging showed no breast abnormalities. A subsequent positron emission tomography (PET) scan showed hypermetabolic lymph nodes and cutaneous uptake in the right axilla. A right axillary lymph node biopsy showed ER negative, PR negative, HER2 positive, and α-methylacyl CoA racemase (AMACR), also known as p504s, positive results in immunohistochemistry, confirming the diagnosis of apocrine adenocarcinoma. Our patient underwent local excision of the primary tumor, neoadjuvant chemotherapy of a carboplatin paclitaxel regimen, a complete right axillary node dissection, and is undergoing maintenance chemotherapy with pembrolizumab.
Conclusion: The diagnosis of apocrine adenocarcinoma is extremely rare, with less than 200 cases reported as of 2024. Our patient also has a partner and localizer of BRCA2 (PALB2) genetic mutation. To our knowledge, there are no reported cases of apocrine adenocarcinoma in a patient with a PALB2 genetic mutation. Standard treatment is wide local excision, with or without chemotherapy depending on lymph node involvement.
Keywords: Apocrine adenocarcinoma, Chemotherapy, PALB2
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Acknowledgments
Photomicrographs provided courtesy of Matthew W. Auten, M.D., Ph.D., Singing River Pathology (Ocean Springs, MS).
Author ContributionsAnna Breland - Analysis of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Tana Cooper - Substantial contributions to conception and design, Acquisition of data, Revising it critically for important intellectual content, Final approval of the version to be published
Guaranter of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this article.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2025 Anna Breland et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
