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Case Reports
. 2017 Jun;44(6):557-562.
doi: 10.1111/cup.12952.

Well-differentiated neuroendocrine tumors in skin: Terminology and diagnostic utility of cytokeratin 5/6 and p63

Gauri Panse  1 , Shawn E Cowper  1   2 , David J Leffell  1 , Melissa Pulitzer  3 , Christine J Ko  1   2
Affiliations
Case Reports

Well-differentiated neuroendocrine tumors in skin: Terminology and diagnostic utility of cytokeratin 5/6 and p63

Gauri Panse et al. J Cutan Pathol. 2017 Jun.

Abstract

Background: Well-differentiated neuroendocrine tumors (WDNETs) in skin include metastases from visceral primary sites and very uncommonly, primary cutaneous carcinoid tumors. Cutaneous WDNET may present a diagnostic challenge and in particular can be mistaken for a benign skin adnexal tumor. In contrast to cutaneous adnexal tumors, metastatic adenocarcinomas to the skin are cytokeratin 5/6 (CK5/6) and p63 negative in the majority of cases. It is unclear if failure to stain with CK5/6 and p63 would be helpful in differentiating WDNETs from cutaneous adnexal neoplasms.

Methods: We reviewed 10 cases of cutaneous WDNETs (8 cases of metastatic disease and 2 presumed primary carcinoid tumors of the skin) and performed immunohistochemical stains for CK5/6 and p63 on all cases.

Results: All 10 cases were negative with both CK5/6 and p63.

Conclusion: Negative staining for CK5/6 and p63 can be helpful to distinguish WDNETs from cutaneous adnexal neoplasms. It is important to consider WDNETs in the differential diagnosis of cutaneous adnexal neoplasms as low-grade tumors may be the first sign of aggressive metastatic disease.

Keywords: CK5/6; cutaneous carcinoid; p63; well-differentiated neuroendocrine tumor.

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