Primary Papillary Mucinous Carcinoma of The Scalp: A Case Report and A Brief Review of Literature

Abstract

Background: Primary papillary mucinous carcinoma of the skin is very uncommon and is seen mainly on the head and neck region. It is difficult to differentiate clinically and pathologically between these primary carcinomas of the skin and the more commonly found mucinous carcinoma distant deposits on the skin from malignancy in the breast and gastrointestinal system.

Case Presentation: We are presenting a case of a 64-year-old lady who presented with a slowly progressive, painful ulcero-proliferative growth on her scalp for 3 years. Incisional biopsy was suggestive of mucinous neoplasm. The patient underwent an oncological workup for another primary malignancy, but no other primary malignancy was detected. Subsequently, the patient underwent wide local excision with local flap reconstruction, and on the basis of the histopathology report, the diagnosis of a primary papillary mucinous carcinoma of the scalp was confirmed.

Discussion: It is a slowly progressive, low-grade carcinoma with the propensity of local tissue invasion and a high recurrence rate. Primary from head and neck, breast, gastrointestinal tract, and pelvic organ must be excluded. Treatment with wide local excision and 1 cm margin or Moh’s microsurgery is advised as these are chemotherapy and radiotherapy-resistant.

Conclusion: Primary papillary mucinous carcinoma of the scalp is a rare tumor, and another primary site of mucinous neoplasm must be ruled out. Wide local excision with adequate margin is the mainstay of treatment.