{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T22:38:31Z","timestamp":1769726311777,"version":"3.49.0"},"reference-count":36,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"14","license":[{"start":{"date-parts":[[2025,10,6]],"date-time":"2025-10-06T00:00:00Z","timestamp":1759708800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Neurosurg Case Lessons"],"published-print":{"date-parts":[[2025,10,6]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>Primary malignant cutaneous adnexal neoplasms are rare and can spread locally or to lymph nodes, and very infrequently to distant sites, such as the brain. Their management is poorly documented, and there are no established clinical practice guidelines for treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBSERVATIONS<\/jats:title>\n                    <jats:p>A 57-year-old male underwent surgery 2 years earlier for adenocarcinoma of the cutaneous adnexa of the right arm. He was admitted to the emergency department with a 15-day history of drowsiness, dysarthria, and signs consistent with frontal lobe involvement. Preoperative MRI revealed a heterogeneous left frontal lobe tumor with contrast enhancement of a solid mass. A craniotomy and complete tumor resection were performed. He then received radiosurgery (27 Gy). MRI studies at 1 and 6 months postoperatively showed complete resection. These tumors are rare and originate from hair follicles, sebaceous glands, or sweat glands. They have an overall 5-year survival rate of 78.2%, but the metastasis rate can range from 15% to 30%. The treatment approaches are not well described in the literature; combinations of surgery, chemotherapy, immunotherapy, targeted therapy, and radiotherapy are utilized.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>LESSONS<\/jats:title>\n                    <jats:p>Malignant cutaneous adnexal neoplasms are rare conditions that need precise diagnosis and prompt multidisciplinary treatment.<\/jats:p>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/thejns.org\/doi\/10.3171\/CASE25447\">https:\/\/thejns.org\/doi\/10.3171\/CASE25447<\/jats:ext-link>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/case25447","type":"journal-article","created":{"date-parts":[[2025,10,7]],"date-time":"2025-10-07T00:02:38Z","timestamp":1759795358000},"source":"Crossref","is-referenced-by-count":1,"title":["Malignant cutaneous adnexal neoplasms with distant brain metastasis: an aggressive behavior. Illustrative cases"],"prefix":"10.3171","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2437-8713","authenticated-orcid":true,"given":"John","family":"Vargas-Urbina","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Hospital Nacional Guillermo Almenara Irigoyen, La Victoria, Lima, Peru"},{"name":"Department of Neurosurgery, Cl\u00ednica Internacional, San Borja, Lima, Peru"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ra\u00fal","family":"Martinez-Silva","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Hospital Nacional Guillermo Almenara Irigoyen, La Victoria, Lima, Peru"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0222-3833","authenticated-orcid":true,"given":"Giuseppe","family":"Rojas-Panta","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Hospital Nacional Guillermo Almenara Irigoyen, La Victoria, Lima, Peru"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-8249-5234","authenticated-orcid":true,"given":"Gabriel","family":"Ponce-Manrique","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Hospital Nacional Guillermo Almenara Irigoyen, La Victoria, Lima, Peru"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jerson","family":"Flores-Castillo","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Hospital Nacional Guillermo Almenara Irigoyen, La Victoria, Lima, Peru"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"William","family":"Anicama-Lima","sequence":"additional","affiliation":[{"name":"Department of Anatomical Pathology, Hospital Nacional Guillermo Almenara Irigoyen, La Victoria, Lima, Peru"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"issue":"5","key":"bib1","series-title":"Ann Gastroenterol","first-page":"581","article-title":"Metastatic adnexal cancer in a man","volume":"30","author":"","year":"2017","unstructured":"Advani R, Izzy M, Akki A, Levine C, Panarelli N, Brandt LJ.Metastatic adnexal cancer in a man. Ann Gastroenterol. 2017;30(5):581-582."},{"issue":"10","key":"bib2","series-title":"Anticancer Res","first-page":"5263","article-title":"Chemotherapy of rare skin adnexal tumors: a review of literature","volume":"34","author":"De Iuliis","year":"2014","unstructured":"De Iuliis FAmoroso LTaglieri LChemotherapy of rare skin adnexal tumors: a review of literature. Anticancer Res. 2014;34(10):5263-5268."},{"issue":"6","key":"bib3","series-title":"J Am Coll Surg","first-page":"889","article-title":"Malignant cutaneous adnexal tumors and role of SLNB","volume":"232","author":"Storino","year":"2021","unstructured":"Storino ADrews RETawa NE.Malignant cutaneous adnexal tumors and role of SLNB. J Am Coll Surg. 2021;232(6):889-898."},{"issue":"8","key":"bib4","series-title":"Am J Dermatopathol","first-page":"618","article-title":"Aggressive extraocular sebaceous carcinoma of the scalp involving the brain in a patient with Muir\u2013Torre syndrome","volume":"38","author":"Hadravsky","year":"2016","unstructured":"Hadravsky LKazakov DVStehlik JAggressive extraocular sebaceous carcinoma of the scalp involving the brain in a patient with Muir\u2013Torre syndrome. Am J Dermatopathol. 2016;38(8):618-622."},{"issue":"2","key":"bib5","series-title":"Ann Surg","first-page":"258","article-title":"Sebaceous gland carcinoma","volume":"115","author":"Beach","year":"1942","unstructured":"Beach ASeverance AO.Sebaceous gland carcinoma. Ann Surg. 1942;115(2):258-266."},{"issue":"5","key":"bib6","series-title":"Cancer","first-page":"1163","article-title":"Adnexal carcinomas of the skin. II. Extraocular sebaceous carcinomas","volume":"56","author":"Wick","year":"1985","unstructured":"Wick MRGoellner JRWolfe JTSu WP.Adnexal carcinomas of the skin. II. Extraocular sebaceous carcinomas. Cancer. 1985;56(5):1163-1172."},{"issue":"6","key":"bib7","series-title":"J Am Acad Dermatol","first-page":"1210","article-title":"Incidence and survival of sebaceous carcinoma in the United States","volume":"75","author":"Tripathi","year":"2016","unstructured":"Tripathi RChen ZLi LBordeaux JS.Incidence and survival of sebaceous carcinoma in the United States. J Am Acad Dermatol. 2016;75(6):1210-1215."},{"issue":"12","key":"bib8","series-title":"J Clin Pathol","first-page":"992","article-title":"Challenges in the diagnosis of cutaneous adnexal tumours","volume":"68","author":"Danialan","year":"2015","unstructured":"Danialan RMutyambizi KAung PPPrieto VGIvan D.Challenges in the diagnosis of cutaneous adnexal tumours. J Clin Pathol. 2015;68(12):992-1002."},{"issue":"2","key":"bib9","series-title":"J Clin Pathol","first-page":"129","article-title":"Skin adnexal neoplasms\u2014part 1: an approach to tumours of the pilosebaceous unit","volume":"60","author":"Alsaad","year":"2007","unstructured":"Alsaad KOObaidat NAGhazarian D.Skin adnexal neoplasms\u2014part 1: an approach to tumours of the pilosebaceous unit. J Clin Pathol. 2007;60(2):129-144."},{"issue":"2","key":"bib10","series-title":"J Stomatol Oral Maxillofac Surg","first-page":"95","article-title":"Les tumeurs cutan\u00e9es malignes \u00e0 diff\u00e9rentiation pilaire de la face et du cuir chevelu: mise au point diagnostique et th\u00e9rapeutique","volume":"118","author":"Romeu","year":"2017","unstructured":"Romeu MFoletti JMChossegros CLes tumeurs cutan\u00e9es malignes \u00e0 diff\u00e9rentiation pilaire de la face et du cuir chevelu: mise au point diagnostique et th\u00e9rapeutique. J Stomatol Oral Maxillofac Surg. 2017;118(2):95-102."},{"issue":"5","key":"bib11","series-title":"J Dtsch Dermatol Ges","first-page":"730","article-title":"S1-guideline sebaceous carcinoma","volume":"22","author":"Utikal","year":"2024","unstructured":"Utikal JNagel PM\u00fcller VS1-guideline sebaceous carcinoma. J Dtsch Dermatol Ges. 2024;22(5):730-747."},{"issue":"1","key":"bib12","series-title":"J Immunother Cancer","first-page":"58","article-title":"Near complete response to Pembrolizumab in microsatellite-stable metastatic sebaceous carcinoma","volume":"6","author":"Domingo-Musibay","year":"2018","unstructured":"Domingo-Musibay EMurugan PGiubellino ANear complete response to Pembrolizumab in microsatellite-stable metastatic sebaceous carcinoma. J Immunother Cancer. 2018;6(1):58."},{"issue":"12","key":"bib13","series-title":"Lancet Oncol","first-page":"e699","article-title":"Sebaceous carcinoma: evidence-based clinical practice guidelines","volume":"20","author":"Owen","year":"2019","unstructured":"Owen JLKibbi NWorley BSebaceous carcinoma: evidence-based clinical practice guidelines. Lancet Oncol. 2019;20(12):e699-e714."},{"issue":"suppl 2","key":"bib14","series-title":"Mod Pathol","first-page":"S93","article-title":"Malignant adnexal neoplasms","volume":"19","author":"Crowson","year":"2006","unstructured":"Crowson ANMagro CMMihm MC.Malignant adnexal neoplasms. Mod Pathol. 2006;19(suppl 2):S93-S126."},{"issue":"2","key":"bib15","series-title":"J Clin Pathol","first-page":"145","article-title":"Skin adnexal neoplasms\u2014part 2: an approach to tumours of cutaneous sweat glands","volume":"60","author":"Obaidat","year":"2007","unstructured":"Obaidat NAAlsaad KOGhazarian D.Skin adnexal neoplasms\u2014part 2: an approach to tumours of cutaneous sweat glands. J Clin Pathol. 2007;60(2):145-159."},{"issue":"2","key":"bib16","series-title":"Am J Clin Oncol","first-page":"131","article-title":"Apocrine gland carcinoma of the axilla: review of the literature and recommendations for treatment","volume":"22","author":"Chamberlain","year":"1999","unstructured":"Chamberlain RSHuber KWhite JCTravaglino-Parda R.Apocrine gland carcinoma of the axilla: review of the literature and recommendations for treatment. Am J Clin Oncol. 1999;22(2):131-135."},{"issue":"35","key":"bib17","series-title":"J Clin Oncol","first-page":"5655","article-title":"Axillary apocrine carcinoma with brain metastases","volume":"25","author":"Gallerani","year":"2007","unstructured":"Gallerani ECiriolo MRossini CCavalli F.Axillary apocrine carcinoma with brain metastases. J Clin Oncol. 2007;25(35):5655-5656."},{"issue":"24","key":"bib18","series-title":"J Clin Oncol","first-page":"e412","article-title":"Metastatic apocrine carcinoma of the scalp: prolonged response to systemic chemotherapy","volume":"28","author":"Tlemcani","year":"2010","unstructured":"Tlemcani KLevine DSmith RVMetastatic apocrine carcinoma of the scalp: prolonged response to systemic chemotherapy. J Clin Oncol. 2010;28(24):e412-e414."},{"issue":"5","key":"bib1","series-title":"Ann Gastroenterol","first-page":"581","article-title":"Metastatic adnexal cancer in a man","volume":"30","author":"","year":"2017","unstructured":"Advani R, Izzy M, Akki A, Levine C, Panarelli N, Brandt LJ.Metastatic adnexal cancer in a man. Ann Gastroenterol. 2017;30(5):581-582."},{"issue":"10","key":"bib2","series-title":"Anticancer Res","first-page":"5263","article-title":"Chemotherapy of rare skin adnexal tumors: a review of literature","volume":"34","author":"De Iuliis","year":"2014","unstructured":"De Iuliis FAmoroso LTaglieri LChemotherapy of rare skin adnexal tumors: a review of literature. Anticancer Res. 2014;34(10):5263-5268."},{"issue":"6","key":"bib3","series-title":"J Am Coll Surg","first-page":"889","article-title":"Malignant cutaneous adnexal tumors and role of SLNB","volume":"232","author":"Storino","year":"2021","unstructured":"Storino ADrews RETawa NE.Malignant cutaneous adnexal tumors and role of SLNB. J Am Coll Surg. 2021;232(6):889-898."},{"issue":"8","key":"bib4","series-title":"Am J Dermatopathol","first-page":"618","article-title":"Aggressive extraocular sebaceous carcinoma of the scalp involving the brain in a patient with Muir\u2013Torre syndrome","volume":"38","author":"Hadravsky","year":"2016","unstructured":"Hadravsky LKazakov DVStehlik JAggressive extraocular sebaceous carcinoma of the scalp involving the brain in a patient with Muir\u2013Torre syndrome. Am J Dermatopathol. 2016;38(8):618-622."},{"issue":"2","key":"bib5","series-title":"Ann Surg","first-page":"258","article-title":"Sebaceous gland carcinoma","volume":"115","author":"Beach","year":"1942","unstructured":"Beach ASeverance AO.Sebaceous gland carcinoma. Ann Surg. 1942;115(2):258-266."},{"issue":"5","key":"bib6","series-title":"Cancer","first-page":"1163","article-title":"Adnexal carcinomas of the skin. II. Extraocular sebaceous carcinomas","volume":"56","author":"Wick","year":"1985","unstructured":"Wick MRGoellner JRWolfe JTSu WP.Adnexal carcinomas of the skin. II. Extraocular sebaceous carcinomas. Cancer. 1985;56(5):1163-1172."},{"issue":"6","key":"bib7","series-title":"J Am Acad Dermatol","first-page":"1210","article-title":"Incidence and survival of sebaceous carcinoma in the United States","volume":"75","author":"Tripathi","year":"2016","unstructured":"Tripathi RChen ZLi LBordeaux JS.Incidence and survival of sebaceous carcinoma in the United States. J Am Acad Dermatol. 2016;75(6):1210-1215."},{"issue":"12","key":"bib8","series-title":"J Clin Pathol","first-page":"992","article-title":"Challenges in the diagnosis of cutaneous adnexal tumours","volume":"68","author":"Danialan","year":"2015","unstructured":"Danialan RMutyambizi KAung PPPrieto VGIvan D.Challenges in the diagnosis of cutaneous adnexal tumours. J Clin Pathol. 2015;68(12):992-1002."},{"issue":"2","key":"bib9","series-title":"J Clin Pathol","first-page":"129","article-title":"Skin adnexal neoplasms\u2014part 1: an approach to tumours of the pilosebaceous unit","volume":"60","author":"Alsaad","year":"2007","unstructured":"Alsaad KOObaidat NAGhazarian D.Skin adnexal neoplasms\u2014part 1: an approach to tumours of the pilosebaceous unit. J Clin Pathol. 2007;60(2):129-144."},{"issue":"2","key":"bib10","series-title":"J Stomatol Oral Maxillofac Surg","first-page":"95","article-title":"Les tumeurs cutan\u00e9es malignes \u00e0 diff\u00e9rentiation pilaire de la face et du cuir chevelu: mise au point diagnostique et th\u00e9rapeutique","volume":"118","author":"Romeu","year":"2017","unstructured":"Romeu MFoletti JMChossegros CLes tumeurs cutan\u00e9es malignes \u00e0 diff\u00e9rentiation pilaire de la face et du cuir chevelu: mise au point diagnostique et th\u00e9rapeutique. J Stomatol Oral Maxillofac Surg. 2017;118(2):95-102."},{"issue":"5","key":"bib11","series-title":"J Dtsch Dermatol Ges","first-page":"730","article-title":"S1-guideline sebaceous carcinoma","volume":"22","author":"Utikal","year":"2024","unstructured":"Utikal JNagel PM\u00fcller VS1-guideline sebaceous carcinoma. J Dtsch Dermatol Ges. 2024;22(5):730-747."},{"issue":"1","key":"bib12","series-title":"J Immunother Cancer","first-page":"58","article-title":"Near complete response to Pembrolizumab in microsatellite-stable metastatic sebaceous carcinoma","volume":"6","author":"Domingo-Musibay","year":"2018","unstructured":"Domingo-Musibay EMurugan PGiubellino ANear complete response to Pembrolizumab in microsatellite-stable metastatic sebaceous carcinoma. J Immunother Cancer. 2018;6(1):58."},{"issue":"12","key":"bib13","series-title":"Lancet Oncol","first-page":"e699","article-title":"Sebaceous carcinoma: evidence-based clinical practice guidelines","volume":"20","author":"Owen","year":"2019","unstructured":"Owen JLKibbi NWorley BSebaceous carcinoma: evidence-based clinical practice guidelines. Lancet Oncol. 2019;20(12):e699-e714."},{"issue":"suppl 2","key":"bib14","series-title":"Mod Pathol","first-page":"S93","article-title":"Malignant adnexal neoplasms","volume":"19","author":"Crowson","year":"2006","unstructured":"Crowson ANMagro CMMihm MC.Malignant adnexal neoplasms. Mod Pathol. 2006;19(suppl 2):S93-S126."},{"issue":"2","key":"bib15","series-title":"J Clin Pathol","first-page":"145","article-title":"Skin adnexal neoplasms\u2014part 2: an approach to tumours of cutaneous sweat glands","volume":"60","author":"Obaidat","year":"2007","unstructured":"Obaidat NAAlsaad KOGhazarian D.Skin adnexal neoplasms\u2014part 2: an approach to tumours of cutaneous sweat glands. J Clin Pathol. 2007;60(2):145-159."},{"issue":"2","key":"bib16","series-title":"Am J Clin Oncol","first-page":"131","article-title":"Apocrine gland carcinoma of the axilla: review of the literature and recommendations for treatment","volume":"22","author":"Chamberlain","year":"1999","unstructured":"Chamberlain RSHuber KWhite JCTravaglino-Parda R.Apocrine gland carcinoma of the axilla: review of the literature and recommendations for treatment. Am J Clin Oncol. 1999;22(2):131-135."},{"issue":"35","key":"bib17","series-title":"J Clin Oncol","first-page":"5655","article-title":"Axillary apocrine carcinoma with brain metastases","volume":"25","author":"Gallerani","year":"2007","unstructured":"Gallerani ECiriolo MRossini CCavalli F.Axillary apocrine carcinoma with brain metastases. J Clin Oncol. 2007;25(35):5655-5656."},{"issue":"24","key":"bib18","series-title":"J Clin Oncol","first-page":"e412","article-title":"Metastatic apocrine carcinoma of the scalp: prolonged response to systemic chemotherapy","volume":"28","author":"Tlemcani","year":"2010","unstructured":"Tlemcani KLevine DSmith RVMetastatic apocrine carcinoma of the scalp: prolonged response to systemic chemotherapy. 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