Abstract：
Primary cutaneous adenoid cystic carcinoma (PCACC) is a rare form of adenoid cystic carcinoma (ACC) arising commonly from the salivary gland. Less often they originate outside the head and neck region, with the scalp being the commonest cutaneous site in 40% of the cases. The presentation on the chest wall is rare, with no reports to date on axillary lymph node metastases. Here we report a case of a 65-year-old female with previously operated PCACC of the chest wall at a different center, showing uptake on positron emission tomography imaging at the site of surgical scar that w as inconclusive on needle biopsy metastasized to the axillary lymph node confirmed by needle biopsy managed with wide local excision, axillary lymph node dissection, and chest wall reconstruction with keystone island flap. The postoperative outcome was uneventful with no recurrence or axillary complications at one year\'s follow-up. She was advised to receive adjuvant radiotherapy; however, she refused. To conclude, though PCACC is rare, they can have an aggressive presentation, and a multidisciplinary approach is necessary for a better outcome.
摘要：
原发性皮肤腺样囊性癌（PCACC）是一种罕见的腺样囊性癌（ACC），通常起源于唾液腺。它们通常起源于头部和颈部区域之外，在40%的病例中，头皮是最常见的皮肤部位。胸壁上的介绍很少见，迄今尚无腋窝淋巴结转移的报告。在这里，我们报告了一例65岁的女性，先前在不同的中心进行了胸壁PCACC手术，在手术疤痕部位的正电子发射断层扫描成像显示摄取，在针吸活检时无法确定转移到腋窝淋巴结，通过针吸活检进行广泛的局部切除，腋窝淋巴结清扫术,梯形岛状皮瓣胸壁重建。术后转归顺利，随访1年无复发或腋窝并发症。她被建议接受辅助放疗；然而，她拒绝了。最后，尽管PCACC很少见，他们可以有一个积极的演讲，和多学科的方法是必要的更好的结果。
