Microcystic adnexal carcinoma with lymph node metastasis.

Microcystic adnexal carcinoma (MAC) affects predominantly the face and seldom metastasizes. We report a case occurring in the axilla of a 63-year-old male. Histology revealed the characteristic features of MAC. Eleven months after the excision, he underwent a reexcision with wide margins because of local recurrence. Histologically, the central area of the recurrent lesion revealed the typical histologic features of MAC, and the periphery showed a proliferation of irregular duct-like and glandular structures with a mixed pattern. Two lymph nodes that were not adherent to the tumor had metastatic tumor cells. The present case confirms that MAC can metastasize, although it may also be hypothesized that the recurrent lesion represented transformation into a higher-grade carcinoma.