Microcystic Adnexal Carcinoma

When people talk about skin cancer, they often think about malignancies like Melanoma, Basal Cell Carcinoma, and Squamous Cell Carcinoma. Although not as common, other types of skin cancer exist and can pose significant risks to your health. Microcystic Adnexal Carcinoma, often referred to by its acronym MAC, is one such malignant growth that can develop on the skin.

What is it?

“This is a lesser known type of cancer that is thought to develop in the sweat glands of the skin,” says Dr. Adam Mamelak, a board-certified Dermatologist and skin cancer expert in Austin, Texas. In fact, although MAC was only official recognized in 1982, a number of people had described it previously but called it different names. Historically, this tumor has been called a malignant syringoma or syringoid carcinoma. Others referred to as a sclerosing sweat duct carcinoma, before MAC became the generally accepted term.

Who gets it?

MAC can occur in both men and women. Although it has been reported at just about every age, from children to the elderly, it is most common in individuals in their 50’s, 60’s and 70’s. The majority of these tumors have been discovered in Caucasian individuals.

How would I get it?

Similar to other types of skin cancer, UV exposure has been considered a main risk factor. This is primarily because most MAC have been reported in sun exposed areas. A significant number of patients have also had previous radiation therapy in the area where MAC arises. The time between the radiation treatment and the development of MAC varies considerably, and has been reported as years, even decades.

What does it look like?

MAC often appears as a slow growing, non-descript nodule or bump on the skin. It can often resemble other tumors such as basal cell carcinoma. It is usually found on the head and neck, with a predilection for the central area of the face and areas around the nose and mouth. “Most patients will notice an indurated bump or plaque, or a cyst-like lesion on the skin,” says Dr. Mamelak.

The real difference is under the microscope. MAC tumors have cords of tumor cells an duct like structures. Cystic structures filled with keratin can also be observed. The tumor cells infiltrate deeply and can wrap around nerves (perineural invasion).

Should I worry about it?

This is considered an invasive infiltrating malignancy that can cause significant local destruction. “The unfortunate thing about this tumor is that is can grow aggressively, taking over and destroying the surrounding tissue in the area,” notes Dr. Mamelak. This makes it extremely important to catch in its earlier stages, and treat the cancer before it grows too big.

How do I treat it?

Treatment of MAC is primarily achieved with surgical excision of the cancerous tissue. “Because of the infiltrating nature of this tumor, Mohs Micrographic Surgery is preferentially used to excise the malignant tissue, without removing excessive amounts of healthy tissue in the process. Using this technique, we can really achieve exceptional results.” Dr. Mamelak completed a rigorous fellowship-training program in Mohs surgery and performs this procedure at Sanova Dermatology and the Austin Mohs Surgery Center. Radiation therapy has also been used in certain situations, with varying results.

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Are you concerned about a skin growth or changing mole? Contact us at Sanova Dermatology today, and set up your skin check.

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