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AIMS Microcystic adnexal carcinoma is a distinctive sweat duct carcinoma of low-grade malignant potential with risk for locally destructive growth and local recurrence. Distant metastases and disease related mortality is exceptional. The histological hallmarks of these tumours are the diffusely infiltrative growth within dermis, the frequent invasion of subcutaneous structures, the presence of perineurial invasion and the bland cytological features. The tumours are organized in cords and strands and show keratocyst formation and duct diffe