Cutaneous Apocrine Carcinoma Masquerading as Head and Neck Cellulitis: An Ominous Sign

Figure 1. Patient presented with a poorly demarcated, erythematous plaque with firm woody edema involving the right cheek and anterior neck.

Figure 2. Biopsy specimens from posterior side of patient's right neck. A, Skin with tumor composed of complex glandular structures (arrows) infiltrating the deep dermis (hematoxylin-eosin, original magnification ×4). B, Tubular formation with luminal secretions and cellular infiltrate with eosinophilic cytoplasm, pleomorphic nuclei, prominent nucleoli, and decapitation secretion (hematoxylin-eosin for both images, original magnification ×40 for the primary image and ×60 for the inset); the arrows in the inset indicate decapitation secretion. C, Under androgen receptor immunohistochemical staining, tumor cells show strong nuclear activity; seen in the top portion of the image as internal controls, normal sebaceous cells also show positive staining (original magnification ×20). D, Gross cystic disease fluid protein 15 immunohistochemical staining is strongly positive in tumor cells (original magnification ×20).