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Soo Park, MD
Soo Park, MD
Posted: Tuesday, April 5, 2022
A recent article published in the European Journal of Cancer highlighted the impact of pathology expert review on the diagnosis of skin adnexal cancer. Maxime Battistella, MD, PhD, of Université Paris Cité, AP-HP Saint-Louis Hospital, and colleagues conducted a prospective analysis of newly diagnosed and suspected skin adnexal carcinomas to determine whether expert pathologic review is needed for the optimal clinical management of patients with this disease. Their findings revealed that a diagnostic change occurred in 21.3% of the patients examined, and most of the diagnosis discrepancies occurred in those with sweat gland carcinomas.
“[T]he rarity of skin adnexal carcinomas and the significant changes of their classification over time have prevented health-care professionals from gaining sufficient clinicopathological experience, and definite diagnosis often requires a specific expertise,” stated Dr. Battistella and colleagues.
The CARADERM (Cancers Rares Deratologiques) network is a national clinicopathologic rare cancer network dedicated to providing expert pathologic review of rare skin cancers and dedicated multidisciplinary care. A total of 2,563 cases were referred to the network for diagnostic review. Of this total, 2,205 were found to have adnexal carcinomas. The review process included 22 experts who received and examined tumor blocks or original stained slides, clinical information, and molecular data to make their diagnosis.
Examination of concordance between referral and expert diagnosis revealed that 1,860 patients had concordant diagnoses (78.3% overall concordance), and 503 (21.7%) had discordant diagnoses. The tumor subtypes with the most discrepancies were malignant mixed tumor (12/25; 48% overall concordance), adenocarcinoma of anogenital mammary-like glands (1/2; 50%), syringocystadenocarcinoma papilliferum (6/11; 54.6%), and cribriform carcinoma (6/11; 54.6%). Additionally, sweat gland carcinomas were significantly more likely to have diagnostic discrepancy (215/847; 25.4% diagnostic discrepancy) than hair follicle carcinoma (99/725; 13.7%), sebaceous carcinoma (35/220; 15.9%), or other subtypes (11/228; 4.8%).
Disclosure: The study authors reported no conflicts of interest.
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