Deceptive Clues: A Case Report of a Histopathologically Ambiguous Axillary Tumor Mimicking Breast Cancer

Summary: A 60-year-old male patient presented to the multidisciplinary dermato-oncological clinic with a left axillary tumor. The histomorphological characteristics had been ambiguous, initially pointing to a local metastasis of an apocrine carcinoma of mammary origin. Only after complete tumor excision and comprehensive diagnostic workup could a definitive diagnosis of primary cutaneous adnexal carcinoma be reached, allowing for appropriate therapy to be commenced.

Medical History & Clinical Findings: The patient had an unremarkable medical history and had presented for excisional biopsy of an axillary nodule. Following the cancer diagnosis, several diagnostic tests and histopathological evaluations were performed in a senological setting to assess the likelihood of metastatic mammary carcinoma. This included breast ultrasonography, CT and MRI imaging and bone scintigraphy. A previously unrecognized subcutaneous mass was identified in the left axilla, located deep to the excised nodule. No further lesions, either mammary or otherwise, were detected.

Diagnosis: The subcutaneous tumor was completely excised with clear margins. Following extensive histopathological analysis, imaging and deliberation in the multidisciplinary tumor board, mammary carcinoma and metastatic disease were ruled out, and the diagnosis of primary cutaneous adnexal carcinoma was reached.

Therapy & Course: In conclusion, adjuvant locoregional radiotherapy could be started. This case highlights the importance of an interdisciplinary approach in diagnosing axillary neoplasms. Although patients may initially present to a senological clinic, maintaining a broad differential diagnosis is crucial, especially when treating tumors with overlapping or atypical features. This prevents misdiagnoses, ensuring timely and effective care, thereby improving patient outcomes.

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Artikel online veröffentlicht:
04. Juni 2025