Adenoid cystic carcinoma is a rare tumor in the skin as attested to by single case reports from the different parts of the world. Accordingly, we wish to add an example from Nigeria with reference to the Ibo ethnic group. The general patterns are worthy of documentation.

Keywords: Skin, Adenoid cystic carcinoma, Case report, World-wide, Ibo, Nigeria

INTRODUCTION

Adenoid cystic carcinoma is well known for its rarity. On this account, a literature search revealed but single case reports from countries as far apart as Brazil [1], Bulgaria [2], Central African Republic [3], Greece [4], India [5], Italy [6] and USA [7]. Accordingly, this paper contributes a case from among the Ibo ethnic group [8], who are domiciled largely in South Eastern Nigeria. Moreover, in keeping with the adage of a Birmingham (UK) group to the effect that the establishment of a histopathology data pool facilitates epidemiological analysis [9] the corresponding author had run such a pool established by the Government of the Eastern Region of Nigeria at Enugu while the co-author ran a Clinic. Their cooperation has resulted in this publication.

CASE REPORT

AU, 68 year old Ibo female, attended the Clinic run by Dr. Nnabuko with complaint of ulcer of the left ala of the nose and naso-labial region for about 1½ years. There were many episodes of self-excision. The episodes resulted in a progressively increasing ulcer. On examination, the ulcer was 3 cm in diameter. The edges were raised, and bled on contact. There was no regional lymphadenopathy. Basal cell carcinoma was provisionally diagnosed. Biopsy was carried out. Thereafter, a distorted ulcerated skin measuring 3 cm across was received by the senior author. On microscopy, there was the picturesque combination of epithelial and cystic elements in malignant disorder. Therefore, adenoid cystic carcinoma was diagnosed.

DISCUSSION

It is of interest that both of us published previously a case report, in which an Ibo male’s albino exhibited a facial ulcer that revealed the tripartite diagnosis of squamous cell carcinoma, basosquamous carcinoma and adenoid cystic carcinoma [10]. Moreover, there was also a local account of albinism associated with adenoid cystic carcinoma as a molecular variant [11].

From our patient aged 68 years, the world pattern rises from 32 years [6], through 40 years [3] and 43 years [2], to 55 years [5] as well as 57 years [1] and 58 years [7]. In other words, the local patient was the oldest.

What of the sex? Our patient was a female. And so were 4 others whereas only 2 were males. Therefore, the picture is clear.

With regard to the site, one patient alone had nasal association [5] like ours. Only the scalp appeared twice [3,6], whereas the rest were a jumble including the eyelid, axilla and chest.

CONCLUSION

Apparently, lymph node metastasis is a rarity in adenoid cystic carcinoma. This occurred only in a Greek woman [4]. Our patient certainly was free of this presentation.

1.       Marback EF, Costa AL, Nossa LM, Marback RL, Rao NA (2003) Eyelid skin adenoid cystic carcinoma: A clinicopathological study of one case simulating sebaceous gland carcinoma. Br J Ophthalmol 87: 118-125.

2.       Tonev ID, Pirgova YS, Conev NV (2015) Primary adenoid cystic carcinoma of the skin with multiple local recurrences. Case Rep Oncol 8: 251-255.

3.       Kobangue L, Djabanga SC, Lenguebanga F, Guéréndo P, Wali Y, et al. (2017) Rare image of generalized adenoid cystic carcinoma of the skin observed in the service of dermatology venereology of Bangui, Central African Republic. Dermatol Case Rep 2: 119.

4.       Rocas D, Asvesti C, Tsega A, Katafygiotis P, Kanitakis J (2014) Primary adenoid cystic carcinoma of the skin metastatic to the lymph nodes: Immunohistochemical study of a new case and literature review. Am J Dermatopathol 36: 223-228.

5.       Singh, Ramesh V (2010) Primary cutaneous adenoid cystic carcinoma with distant metastasis: A case report and brief literature review. Indian J Dermatol Venereol Leprol 76: 176-179.

6.       Cacchi C, Persechino S, Fidanza L, Bartolazzi A (2011) A primary cutaneous adenoid-cystic carcinoma in a young woman: Differential diagnosis and clinical implications. Rare Tumors 3: e3.

7.       Xu YG, Hinshaw M, Longley BJ, Ilyas H, Snow SN (2010) Cutaneous adenoid cystic carcinoma with perineural invasion treatment by Mohs micrography surgery: A case report with literature review. J Oncol 2010: 1-5.

8.       Basden GT (1966) Niger Ibos. Lond: Cass.

9.       Macartney JC, Rollaston TP, Codling BW (1980) Use of a histopathology data pool for epidemiological analysis. J Clin Pathol 33: 351-353.

10.    Onuigbo WIB, Nnabuko R.E (2009) Three different carcinomas clustered in one facial focus in albino. Nig J Surg Sci 19: 38-40.

11.    Onuigbo WIB (2016) Adenocystic carcinoma as a molecular variant of albino skin cancer. J Med Diagn Meth 5: 1.