Primary cutaneous gland apocrine carcinoma, a subtype of sweat gland carcinoma, is an extremely rare malignancy and only a few cases have been reported in the literature. It involves the axillary region but can occur elsewhere on the skin. It is indolent and slow growing. Treatment remains surgical with wide local excision and healthy margins, with or without lymph node dissection. We report a case of a 79-year-old man who came to our hospital with a cauliflower-like mass in the right axilla measuring 1.5 × 1 cm. Histological evaluation showed features of apocrine gland carcinoma arising in an area of high apocrine gland density. The objective of this work is to highlight the diagnostic difficulty that this entity can present and the importance of anatomopathological examination to make the diagnosis and eliminate differential diagnoses.