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Drozdowski R, Grant-Kels JM, Falcone M, Stewart CL. Adnexal neoplasms of the eye. Clin Dermatol 2024; 42:321-342. [PMID: 38281687 DOI: 10.1016/j.clindermatol.2024.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2024]
Abstract
Adnexal neoplasms of the eyelid encompass a wide variety of benign and malignant tumors of sebaceous, follicular, and sweat gland origin. Due to the specialized structures of the eyelid, these neoplasms present differently when compared with those of other locations. Although most dermatologists and ophthalmologists are familiar with the commonly reported adnexal tumors of the eyelid, such as hidrocystoma, pilomatrixoma, and sebaceous carcinoma, many other adnexal neoplasms have been reported at this unique anatomic site. Accurate and timely identification of these neoplasms is essential, as alterations of eyelid anatomy and function can have a negative impact on eye health, vision, and quality of life. We review the clinical and histopathologic features of common and rare eyelid adnexal neoplasms and discuss proposed treatment options.
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Affiliation(s)
- Roman Drozdowski
- Department of Dermatology, University of Connecticut School of Medicine, Farmington, Connecticut, USA
| | - Jane M Grant-Kels
- Department of Dermatology, University of Connecticut School of Medicine, Farmington, Connecticut, USA; Department of Dermatology, University of Florida College of Medicine, Gainesville, Florida, USA
| | - Madina Falcone
- Division of Ophthalmology, Department of Surgery, University of Connecticut School of Medicine, Farmington, Connecticut, USA
| | - Campbell L Stewart
- Department of Dermatology, University of Connecticut School of Medicine, Farmington, Connecticut, USA.
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2
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Holst S, Weber AK, Meier F, Otte J, Petzsch P, Reifenberger J, Wachtmeister T, Westphal D, Ziemer M, Wruck W, Adjaye J, Betz RC, Rütten A, Surowy HM, Redler S. Gene expression profiling in porocarcinoma indicates heterogeneous tumor development and substantiates poromas as precursor lesions. J Dtsch Dermatol Ges 2024. [PMID: 38899945 DOI: 10.1111/ddg.15445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 04/02/2024] [Indexed: 06/21/2024]
Abstract
BACKGROUND AND OBJECTIVES Malignant sweat gland tumors are rare, with the most common being eccrine porocarcinoma (EP). Approximately 18% of benign eccrine poroma (EPO) transit to EP. Previous research has provided first insights into the mutational landscape of EP. However, only few studies have performed gene expression analyses. This leaves a gap in the understanding of EP biology and potential drivers of malignant transformation from EPO to EP. METHODS Transcriptome profiling of 23 samples of primary EP and normal skin (NS). Findings from the EP samples were then tested in 17 samples of EPO. RESULTS Transcriptome profiling revealed diversity in gene expression and indicated biologically heterogeneous sub-entities as well as widespread gene downregulation in EP. Downregulated genes included CD74, NDGR1, SRRM2, CDC42, ANXA2, KFL9 and NOP53. Expression levels of CD74, NDGR1, SRRM2, ANXA2, and NOP53 showed a stepwise-reduction in expression from NS via EPO to EP, thus supporting the hypothesis that EPO represents a transitional state in EP development. CONCLUSIONS We demonstrated that EP is molecularly complex and that evolutionary trajectories correspond to tumor initiation and progression. Our results provide further evidence implicating the p53 axis and the EGFR pathway. Larger samples are warranted to confirm our findings.
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Affiliation(s)
- Svenja Holst
- Institute of Human Genetics, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Anna K Weber
- Institute of Human Genetics, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Friedegund Meier
- Department of Dermatology, University Hospital Carl Gustav Carus, TU Dresden, Germany
- Skin Cancer Center at the University Cancer Centre Dresden and National Center for Tumor Diseases, Dresden, Germany
| | - Jörg Otte
- Institute for Stem Cell Research and Regenerative Medicine, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
- Childhood Cancer Research Unit, Department of Women's and Children's Health, Karolinska Institute, Stockholm, Sweden
| | - Patrick Petzsch
- Biological and Medical Research Centre (BMFZ), Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Julia Reifenberger
- Department of Dermatology, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Thorsten Wachtmeister
- Biological and Medical Research Centre (BMFZ), Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Dana Westphal
- Department of Dermatology, University Hospital Carl Gustav Carus, TU Dresden, Germany
- Skin Cancer Center at the University Cancer Centre Dresden and National Center for Tumor Diseases, Dresden, Germany
| | - Mirjana Ziemer
- Department of Dermatology, University Medical Center Leipzig, Leipzig, Germany
| | - Wasco Wruck
- Institute for Stem Cell Research and Regenerative Medicine, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - James Adjaye
- Institute for Stem Cell Research and Regenerative Medicine, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Regina C Betz
- Institute of Human Genetics, University of Bonn, Medical Faculty and University Hospital Bonn, Bonn, Germany
| | - Arno Rütten
- Dermatopathology, Bodensee, Siemensstrasse 6/1, 88048, Friedrichshafen, Germany
| | - Harald M Surowy
- Institute of Human Genetics, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Silke Redler
- Institute of Human Genetics, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
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3
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Zagala R, Dalle S, Beylot-Barry M, Meyer N, Saiag P, Kramkimel N, Lebbe C, Zehou O, Amini-Adle M, Grob JJ, Arnault JP, Maubec E, Granel-Brocard F, Cribier B, Quereux G, Brunet-Possenti F, Dalac S, Dereure O, Drumez E, Mortier L, Battistella M, Jouary T. Radiotherapy and prognostic factors in adnexal carcinomas: A retrospective study of 657 patients from the French CARADERM network. J Eur Acad Dermatol Venereol 2024. [PMID: 38864258 DOI: 10.1111/jdv.20155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2023] [Accepted: 04/16/2024] [Indexed: 06/13/2024]
Abstract
BACKGROUND Cutaneous adnexal carcinomas are a heterogeneous group of rare neoplasms. Surgical excision is the first-line treatment in localized stage. The use and effectiveness of radiotherapy have not been thoroughly evaluated in these neoplasms. OBJECTIVES The present work analyses prognostic factors on outcomes in skin adnexal carcinomas, based on data from the CARADERM (CAncers RAres DERMatologiques) database. METHODS Data were collected retrospectively including demographic data, tumour types and therapeutic characteristics of all patients included in the CARADERM database, with at least one informative follow-up visit. Analyses were performed on three populations: patients with complete resection of the primary tumour (ADJ/primary population), patients achieving complete remission after complete resection of a recurrent tumour (ADJ/recurrent population) and patients with unresectable locally advanced or metastatic tumours (ADV/MET population). Overall and recurrence/progression-free survivals at 3-year were analysed using Cox regression models. RESULTS Radiotherapy did not affect overall survival (OS) in the ADJ/primary population. Adjusted recurrence-free survival (RFS) was significantly lower in the radiotherapy group in ADJ/primary group. Older patients had significantly poorer OS and RFS. Tumour size and immunosuppression were significantly associated with poorer RFS only. Radiotherapy had no effect on OS and RFS in the ADJ/recurrent population. Age was the only factor associated with a poorer OS. Radiotherapy was significantly associated with longer progression-free survival (PFS) in age-sex adjusted analysis in the ADV/MET population, without effect on OS. CONCLUSIONS Our study shows that age, tumour size and immunosuppression are significantly associated with survival in localized adnexal carcinomas. Radiotherapy may improve PFS in the ADV/MET population but not in localized and recurrent carcinomas after complete excision.
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Affiliation(s)
- Robin Zagala
- Dermatology Department, CH Pau, Pau, France
- Dermatology Department, CHU Bordeaux, Bordeaux, France
| | - Stephane Dalle
- Dermatology Department, Hospices Civils de Lyon, Pierre Bénite, France
- INSERM 1052, CNRS 5286, Centre Léon Bérard, Cancer Research Center of Lyon, Université de Lyon, Université Claude Bernard Lyon 1, Lyon, France
| | - Marie Beylot-Barry
- Dermatology Department, CHU Bordeaux, Bordeaux, France
- University Medical Research Unit (UMR) 1312, Bordeaux Institute of Oncology, Team 5 Translational Research on Oncodermatology and Orphean Skin Diseases, University of Bordeaux, Bordeaux, France
| | | | - Philippe Saiag
- Department of General and Oncologic Dermatology, Ambroise Paré Hospital, APHP, Boulogne-Billancourt, France
- EA 4340 "Biomarkers in Cancerology and Hemato-Oncology", UVSQ, Université Paris-Saclay, Boulogne-Billancourt, France
| | - Nora Kramkimel
- Dermatology Department, Cochin Hospital, APHP, Paris, France
| | - Celeste Lebbe
- Université Paris Cite, Dermato-Oncology and CIC AP-HP Hôpital Saint Louis, Cancer Institute APHP. Nord-Université Paris Cite, Paris, France
- INSERM U976 HIPI, Saint-Louis Hospital, Paris, France
| | - Ouidad Zehou
- Dermatology Department, Hôpital Henri Mondor, Créteil, France
| | - Mona Amini-Adle
- Dermatology Department, Centre Léon Bérard, Cancer Research Center of Lyon, Lyon, France
| | | | | | - Eve Maubec
- Department of Dermatology, APHP, Hôpital Avicenne University Hospital, Bobigny, France
- UMRS-11 24, Campus Paris Saint-Germain-Des-Prés, Paris University, Paris, France
| | | | | | | | | | - Sophie Dalac
- Dermatology Department, CHU Dijon, Dijon, France
| | - Olivier Dereure
- Dermatology Department, CHU Montpellier, Montpellier, France
| | | | - Laurent Mortier
- Dermatology Department, CHU Lille, Lille, France
- Inserm U1189, Lille University, Lille, France
| | - Maxime Battistella
- INSERM U976 HIPI, Saint-Louis Hospital, Paris, France
- Université Paris Cite, Pathology Department, AP-HP Hôpital Saint Louis, Cancer Institute APHP. Nord-Université Paris Cite, Paris, France
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4
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Kervarrec T, Battistella M, Macagno N. [Cutaneous adnexal tumours: Development and synthesis of diagnostic fusion genes]. Ann Pathol 2024:S0242-6498(24)00118-4. [PMID: 38839526 DOI: 10.1016/j.annpat.2024.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2024] [Revised: 04/24/2024] [Accepted: 05/02/2024] [Indexed: 06/07/2024]
Abstract
Cutaneous adnexal tumours are a heterogeneous group of epithelial lesions that includes tumours with follicular, sudoral and/or sebaceous differentiation, or even several combined lines of differentiation. Over the last few years, molecular analysis of these lesions has allowed to identify specific molecular events responsible for tumour development in an increasing number of tumour types. Like other rare neoplasms, such as soft tissue tumours, adnexal tumours display fusion genes resulting from chromosomal translocations that may be specific for the diagnosis if molecular data are properly integrated in the clinical and morphological setting. Molecular testing of adnexal tumours is valuable as it allows to strengthen the robustness of the diagnosis for a group of tumours displaying a wide morphological spectrum. It has allowed to refine the diagnostic criteria and to develop increasingly specific diagnostic immunostainings. Finally, molecular testing has been responsible for the identification of new entities or morphological subtypes of previously known entities. The aim of this review is to provide an update on cutaneous adnexal tumours associated with fusion genes and to evaluate the impact of molecular data on the diagnosis of these lesions.
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Affiliation(s)
- Thibault Kervarrec
- Department of Pathology, université de Tours, hôpital Trousseau, CHRU de Tours, 37044 Tours, France; « Biologie des infections à polyomavirus » team, UMR Inra ISP 1282, université de Tours, Tours, France; CARADERM Network, Lille, France.
| | - Maxime Battistella
- CARADERM Network, Lille, France; Department of Pathology, hôpital Saint-Louis, université Paris 7, AP-HP, Paris, France
| | - Nicolas Macagno
- CARADERM Network, Lille, France; Department of Pathology, Timone University Hospital, Marseille, France
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5
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Kervarrec T, Westphal D, Pissaloux D, Legrand M, Tirode F, Neuhart A, Drouot F, Becker JC, Macagno N, Seris A, Jouary T, Beltzung F, Jullie ML, Harms PW, Cribier B, Mourah S, Jouenne F, Fromont G, Louveau B, Mancini M, Kazakov DV, de la Fouchardière A, Battistella M. Porocarcinomas with PAK1/2/3 fusions: a series of 12 cases. Histopathology 2024. [PMID: 38785043 DOI: 10.1111/his.15214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 04/16/2024] [Accepted: 05/09/2024] [Indexed: 05/25/2024]
Abstract
AIMS Porocarcinoma is a malignant sweat gland tumour differentiated toward the upper part of the sweat duct and may arise from the transformation of a preexisting benign poroma. In 2019, Sekine et al. demonstrated the presence of YAP1::MAML2 and YAP1::NUTM1 fusions in most poromas and porocarcinomas. Recently, our group identified PAK2-fusions in a subset of benign poromas. Herein we report a series of 12 porocarcinoma cases harbouring PAK1/2/3 fusions. METHODS AND RESULTS Five patients were male and the median age was 79 years (ranges: 59-95). Tumours were located on the trunk (n = 7), on the thigh (n = 3), neck (n = 1), or groin area (n = 1). Four patients developed distant metastases. Microscopically, seven cases harboured a benign poroma component and a malignant invasive part. Ductal formations were observed in all, while infundibular/horn cysts and cells with vacuolated cytoplasm were detected in seven and six tumours, respectively. In three cases, the invasive component consisted of a proliferation of elongated cells, some of which formed pseudovascular spaces, whereas the others harboured a predominant solid or trabecular growth pattern. Immunohistochemical staining for CEA and EMA confirmed the presence of ducts. Focal androgen receptor expression was detected in three specimens. Whole RNA sequencing evidenced LAMTOR1::PAK1 (n = 2), ZDHHC5::PAK1 (n = 2), DLG1::PAK2, CTDSP1::PAK1, CTNND1::PAK1, SSR1::PAK3, CTNNA1::PAK2, RNF13::PAK2, ROBO1::PAK2, and CD47::PAK2. Activating mutation of HRAS (G13V, n = 3, G13R, n = 1, Q61L, n = 2) was present in six cases. CONCLUSION Our study suggests that PAK1/2/3 fusions is the oncogenic driver of a subset of porocarcinomas lacking YAP1 rearrangement.
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Affiliation(s)
- Thibault Kervarrec
- Department of Pathology, Centre Hospitalier Universitaire de Tours, Université de Tours, Tours, France
- "Biologie des infections à polyomavirus" Team, UMR INRA ISP 1282, Université de Tours, Tours, France
- CARADERM Network
| | - Danna Westphal
- National Center for Tumour Diseases (NCT), Partner Site Dresden, Dresden, Germany
- Department of Dermatology, University Hospital Carl Gustav Carus, Dresden, Germany
| | - Daniel Pissaloux
- Department of Biopathology, Center Léon Bérard, Lyon, France
- Cancer Research Center of Lyon, Université de Lyon, Université Claude Bernard Lyon 1, INSERM 1052, CNRS 5286, Centre Léon Bérard, Equipe Labellisée Ligue contre le Cancer, Lyon, France
| | - Mélanie Legrand
- Department of Pathology, Centre Hospitalier Universitaire de Tours, Université de Tours, Tours, France
| | - Franck Tirode
- Department of Biopathology, Center Léon Bérard, Lyon, France
- Cancer Research Center of Lyon, Université de Lyon, Université Claude Bernard Lyon 1, INSERM 1052, CNRS 5286, Centre Léon Bérard, Equipe Labellisée Ligue contre le Cancer, Lyon, France
| | - Anne Neuhart
- Department of Biopathology, Center Léon Bérard, Lyon, France
- Cancer Research Center of Lyon, Université de Lyon, Université Claude Bernard Lyon 1, INSERM 1052, CNRS 5286, Centre Léon Bérard, Equipe Labellisée Ligue contre le Cancer, Lyon, France
| | | | - Jürgen C Becker
- Department of Translational Skin Cancer Research, University Hospital Essen, Essen, Germany
- Department of Dermatology, University Hospital Essen, Essen, Germany
- German Cancer Consortium (DKTK), Pa German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Nicolas Macagno
- CARADERM Network
- Department of Pathology, Timone University Hospital, Marseille, France
| | - Alice Seris
- CARADERM Network
- Service de Dermatologie, Centre hospitalier de Pau, Pau, France
| | - Thomas Jouary
- CARADERM Network
- Service de Dermatologie, Centre hospitalier de Pau, Pau, France
| | - Fanny Beltzung
- Department of Pathology, Hôpital Haut-Lévêque, CHU de Bordeaux, Pessac, France
| | - Marie-Laure Jullie
- CARADERM Network
- Department of Pathology, Hôpital Haut-Lévêque, CHU de Bordeaux, Pessac, France
| | - Paul W Harms
- Department of Pathology, Michigan Medicine/University of Michigan, Ann Arbor, MI, USA
- Department of Dermatology, Michigan Medicine/University of Michigan, Ann Arbor, MI, USA
| | - Bernard Cribier
- Dermatology Clinic, Hopitaux Universitaires & Université de Strasbourg, Hopital Civil, Strasbourg, France
| | - Samia Mourah
- Department of Pharmacology and Solid Tumor Genomics, Saint Louis Hospital, Paris University, AP-HP, Paris, France
| | - Fanélie Jouenne
- Department of Pharmacology and Solid Tumor Genomics, Saint Louis Hospital, Paris University, AP-HP, Paris, France
| | - Gaelle Fromont
- Department of Pathology, Centre Hospitalier Universitaire de Tours, Université de Tours, Tours, France
| | - Baptiste Louveau
- Department of Pharmacology and Solid Tumor Genomics, Saint Louis Hospital, Paris University, AP-HP, Paris, France
| | - Maxence Mancini
- Department of Pharmacology and Solid Tumor Genomics, Saint Louis Hospital, Paris University, AP-HP, Paris, France
| | - Dmitry V Kazakov
- IDP Dermatohistopathologie Institut, Pathologie Institut Enge, Zurich, Switzerland
| | - Arnaud de la Fouchardière
- CARADERM Network
- National Center for Tumour Diseases (NCT), Partner Site Dresden, Dresden, Germany
- Department of Dermatology, University Hospital Carl Gustav Carus, Dresden, Germany
| | - Maxime Battistella
- CARADERM Network
- Department of Pathology, APHP Hôpital Saint Louis, INSERM U976, Université Paris Cité7, Paris, France
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Kučinskaitė A, Ulianskaitė G, Pamedys J, Stundys D. Navigating Head and Neck Porocarcinoma: Systematic Review with Special Emphasis on Surgical Safety Margins. Cancers (Basel) 2024; 16:1264. [PMID: 38610942 PMCID: PMC11011095 DOI: 10.3390/cancers16071264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Revised: 03/17/2024] [Accepted: 03/21/2024] [Indexed: 04/14/2024] Open
Abstract
Eccrine porocarcinoma, sharing many features with other skin tumours, is diagnostically challenging. A conventional biopsy might be misleading and surgical excision becomes a primary diagnostic tool and a treatment method. However, the data on surgical safety margins are not consistent. We present a systematic review analysing the surgical margins of porocarcinoma in the head and neck area, which was conducted across the PubMed, Cochrane, and Web of Science databases including studies published from inception to November of 2023. In this systematic review, the PRISMA-ScR checklist was used, and a Cohen's Kappa coefficient of 0.92 was applied, indicating very good agreement between reviewers. Out of 529 identified articles, 18 studies yielding 20 cases in total were selected for a thorough analysis. Nine (45%) cases were observed in the facial regions, eight (40%) on the scalp, and three (5%) on the neck. The primary treatment of choice was wide local excision with safety margins ranging from 3 to 22 mm (mean: 10.1). It demonstrated that surgical margins do not differ by age or anatomic regions, with the main point of reference being the tumour size. As observed, the bigger the tumour, the wider the safety margins were. However, the limited disclosure of surgical safety margins in analysed case reports impeded our ability to define the minimum safety margins. Further investigation and a consensus on recommended safety margins are required.
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Affiliation(s)
| | - Gintarė Ulianskaitė
- Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, 03101 Vilnius, Lithuania;
| | - Justinas Pamedys
- National Centre of Pathology Affiliated to Vilnius University Hospital Santaros Klinikos, 08406 Vilnius, Lithuania;
| | - Domantas Stundys
- Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, 03101 Vilnius, Lithuania;
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7
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Wu ZW, Zhu WJ, Huang S, Tan Q, You C, Hu DG, Li LN. Eccrine porocarcinoma in the tempus of an elderly woman: A case report. World J Clin Cases 2024; 12:1523-1529. [PMID: 38576807 PMCID: PMC10989442 DOI: 10.12998/wjcc.v12.i8.1523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2023] [Revised: 01/19/2024] [Accepted: 02/22/2024] [Indexed: 03/12/2024] Open
Abstract
BACKGROUND Eccrine porocarcinoma (EPC) is a rare skin tumor that mainly affects the elderly population. Tumors often present with slow growth and a good prognosis. EPCs are usually distinguished from other skin tumors using histopathology and immunohistochemistry. However, surgical management alone may be inadequate if the tumor has metastasized. However, currently, surgical resection is the most commonly used treatment modality. CASE SUMMARY A seventy-four-year-old woman presented with a slow-growing nodule in her left temporal area, with no obvious itching or pain, for more than four months. Histopathological examination showed small columnar and short spindle-shaped cells; thus, basal cell carcinoma was suspected. However, immunohistochemical analysis revealed the expression of cytokeratin 5/6, p63 protein, p16 protein, and Ki-67 antigen (40%), and EPC was taken into consideration. The skin biopsy was repeated, and hematoxylin and eosin staining revealed ductal differentiation in some cells. Finally, the patient was diagnosed with EPC, and Mohs micrographic surgery was performed. We adapted follow-up visits in a year and not found any recurrence of nodules. CONCLUSION This case report emphasizes the diagnosis and differentiation of EPC.
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Affiliation(s)
- Zhi-Wei Wu
- Department of Dermatology, First Affiliated Hospital of Gannan Medical University, Ganzhou 341000, Jiangxi Province, China
| | - Wen-Jie Zhu
- Department of Dermatology, First Affiliated Hospital of Gannan Medical University, Ganzhou 341000, Jiangxi Province, China
| | - Shan Huang
- Department of Laser and Cosmetic Dermatology, Ganzhou Dermatology Hospital, Ganzhou 341000, Jiangxi Province, China
| | - Qi Tan
- Department of Dermatology, Tongxiang Dermatology Hospital, Jiaxing 314000, Zhejiang Province, China
| | - Cong You
- Department of Dermatology, First Affiliated Hospital of Gannan Medical University, Ganzhou 341000, Jiangxi Province, China
| | - Dian-Gui Hu
- Department of Infectious Diseases, The Fifth people’s Hospital of Ganzhou, Ganzhou 341000, Jiangxi Province, China
| | - Long-Nian Li
- Department of Dermatology, First Affiliated Hospital of Gannan Medical University, Ganzhou 341000, Jiangxi Province, China
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8
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Kervarrec T, Pissaloux D, Tirode F, de la Fouchardière A, Sohier P, Frouin E, Hamard A, Houben R, Schrama D, Barlier A, Cribier B, Battistella M, Macagno N. Gene fusions in poroma, porocarcinoma and related adnexal skin tumours: An update. Histopathology 2024; 84:266-278. [PMID: 37609771 DOI: 10.1111/his.15023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 07/24/2023] [Accepted: 07/25/2023] [Indexed: 08/24/2023]
Abstract
Poroma is a benign sweat gland tumour showing morphological features recapitulating the superficial portion of the eccrine sweat coil. A subset of poromas may transform into porocarcinoma, its malignant counterpart. Poroma and porocarcinoma are characterised by recurrent gene fusions involving YAP1, a transcriptional co-activator, which is controlled by the Hippo signalling pathway. The fusion genes frequently involve MAML2 and NUTM1, which are also rearranged in other cutaneous and extracutaneous neoplasms. We aimed to review the clinical, morphological and molecular features of this category of adnexal neoplasms with a special focus upon emerging differential diagnoses, and discuss how their systematic molecular characterisation may contribute to a standardisation of diagnosis, more accurate classification and, ultimately, refinement of their prognosis and therapeutic modalities.
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Affiliation(s)
- Thibault Kervarrec
- CARADERM, French Network of Rare Cutaneous Cancer, Lille, France
- Department of Pathology, University Hospital of Tours, Tours, France
- 'Biologie des infections à polyomavirus' Team, UMR1282 INRAE, University of Tours, Tours, France
| | | | - Franck Tirode
- Department of Biopathology, Center Léon Bérard, Lyon, France
- Centre Léon Bérard, Cancer Research Center of Lyon, Equipe Labellisée, University of Lyon, Université Claude Bernard Lyon 1, INSERM 1052, CNRS 5286, Lyon, France
| | - Arnaud de la Fouchardière
- CARADERM, French Network of Rare Cutaneous Cancer, Lille, France
- Department of Biopathology, Center Léon Bérard, Lyon, France
- Centre Léon Bérard, Cancer Research Center of Lyon, Equipe Labellisée, University of Lyon, Université Claude Bernard Lyon 1, INSERM 1052, CNRS 5286, Lyon, France
| | - Pierre Sohier
- CARADERM, French Network of Rare Cutaneous Cancer, Lille, France
- Department of Pathology, Hôpital Cochin, AP-HP, AP-HP Centre - Université Paris Cité, Paris, France
- Faculté de Médecine, University Paris Cité, Paris, France
| | - Eric Frouin
- CARADERM, French Network of Rare Cutaneous Cancer, Lille, France
- Department of Pathology, University Hospital of Poitiers, University of Poitiers, LITEC, Poitiers, France
| | - Aymeric Hamard
- Department of Pathology, University Hospital of Tours, Tours, France
| | - Roland Houben
- Department of Dermatology, Venereology and Allergology, University Hospital Würzburg, Würzburg, Germany
| | - David Schrama
- Department of Dermatology, Venereology and Allergology, University Hospital Würzburg, Würzburg, Germany
| | - Anne Barlier
- Aix-Marseille Univ, INSERM, MMG, U1251, Marmara Institute, Marseille, France
- Laboratory of Molecular Biology, La Conception Hospital, Marseille, France
| | - Bernard Cribier
- CARADERM, French Network of Rare Cutaneous Cancer, Lille, France
- Clinique Dermatologique, Hôpital Civil, Hôpitaux Universitaires, Université de Strasbourg, Strasbourg, France
| | - Maxime Battistella
- CARADERM, French Network of Rare Cutaneous Cancer, Lille, France
- Department of Pathology, Hospital Saint-Louis, AP-HP, Université Paris Cité, INSERM U976, Paris, France
| | - Nicolas Macagno
- CARADERM, French Network of Rare Cutaneous Cancer, Lille, France
- Aix-Marseille Univ, INSERM, MMG, U1251, Marmara Institute, Marseille, France
- Department of Pathology, APHM, Timone University Hospital, Marseille, France
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9
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Chan SPY, Low CE, Yau CE, Lin TP, Wang W, Xiu SX, Tang PY, Luo B, Noor NFBM, Lee KA, Chiang J, Toh TB, Chow EKH, Yang VS. Pazopanib elicits remarkable response in metastatic porocarcinoma: a functional precision medicine approach. Cold Spring Harb Mol Case Stud 2023; 9:a006308. [PMID: 37945347 PMCID: PMC10815280 DOI: 10.1101/mcs.a006308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 10/31/2023] [Indexed: 11/12/2023] Open
Abstract
Metastatic porocarcinomas (PCs) are vanishingly rare, highly aggressive skin adnexal tumors with mortality rates exceeding 70%. Their rarity has precluded the understanding of their disease pathogenesis, let alone the conduct of clinical trials to evaluate treatment strategies. There are no effective agents for unresectable PCs. Here, we successfully demonstrate how functional precision medicine was implemented in the clinic for a metastatic PC with no known systemic treatment options. Comprehensive genomic profiling of the tumor specimen did not yield any actionable genomic aberrations. However, ex vivo drug testing predicted pazopanib efficacy, and indeed, administration of pazopanib elicited remarkable clinicoradiological response. Pazopanib and its class of drugs should be evaluated for efficacy in other cases of PC, and the rationale for efficacy should be determined when PC tumor models become available. A functional precision medicine approach could be useful to derive effective treatment options for rare cancers.
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Affiliation(s)
- Sharon Pei Yi Chan
- Cancer Science Institute of Singapore, National University of Singapore, Singapore
| | - Chen Ee Low
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Chun En Yau
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Tzu Ping Lin
- Translational Precision Oncology Laboratory, Institute of Molecular and Cell Biology, A*STAR, Singapore
| | - Weining Wang
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore
| | - Sam Xin Xiu
- Department of Anatomical Pathology, Singapore General Hospital, Singapore
| | - Po Yin Tang
- Department of Anatomical Pathology, Singapore General Hospital, Singapore
| | - Baiwen Luo
- The N1 Institute for Health, National University of Singapore, Singapore
| | | | - Kristen Alexa Lee
- Department of Vascular and Interventional Radiology, Singapore General Hospital, Singapore
| | - Jianbang Chiang
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore
| | - Tan Boon Toh
- The N1 Institute for Health, National University of Singapore, Singapore
- The Institute for Digital Medicine (WisDM), Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Edward Kai-Hua Chow
- Cancer Science Institute of Singapore, National University of Singapore, Singapore
- The N1 Institute for Health, National University of Singapore, Singapore
- The Institute for Digital Medicine (WisDM), Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- NUS Centre for Cancer Research (N2CR), Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Valerie Shiwen Yang
- Translational Precision Oncology Laboratory, Institute of Molecular and Cell Biology, A*STAR, Singapore;
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore
- SingHealth Duke-NUS Oncology Academic Clinical Program, Duke-NUS Medical School, Singapore
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10
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Campbell K, Quiroga EF, Dunn A, Zoumberos N, Quick CM. Eccrine Porocarcinoma of the Vulva With Sarcomatoid Transformation, a New Human Papillomavirus-associated Malignancy? Case Report and Review of the Literature. Int J Gynecol Pathol 2023; 42:561-566. [PMID: 37406346 DOI: 10.1097/pgp.0000000000000963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/07/2023]
Abstract
Eccrine porocarcinoma is a rare cutaneous neoplasm, and rarer still in the anogenital region. In the vulva, the most common carcinoma by far is squamous cell carcinoma; however, eccrine porocarcinoma can arise at this site. As the distinction between porocarcinoma and squamous cell carcinoma has important prognostic implications at other cutaneous sites, it stands to reason that it may have these same implications in the vulva. We present a case of an eccrine porocarcinoma in the vulva of a 70-year-old woman that, in addition, showed sarcomatoid transformation. This tumor harbored human papillomavirus-18 DNA and mRNA, raising the question of the role of the oncogenic virus in sweat gland neoplasms of the vulva.
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11
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Shao X, Dong Y, Liu H, Wei J, Xiong X. Eccrine Poroma with Concurrent Basal Cell Carcinoma: A Rare Combination. Clin Cosmet Investig Dermatol 2023; 16:2965-2970. [PMID: 37881203 PMCID: PMC10595198 DOI: 10.2147/ccid.s428611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 09/30/2023] [Indexed: 10/27/2023]
Abstract
Eccrine poroma (EP) is a benign skin appendicular tumor that differentiates into the terminal sweat duct and is often differentiated from basal cell carcinoma (BCC) and seborrheic keratosis. This report describes a 58-year-old woman who presented with left occipital plaque. Histopathological analysis showed that the tumor cells were located in the lower part of the epidermis. The tumor cells were cuboidal or circular basal-like cells of the same size. The surrounding cells were not arranged in a palisade shape. Scattered tumor clusters composed of basal-like cells were also seen in the dermis, staining basophilic, and the surrounding cells were arranged in a palisade pattern. Immunohistochemistry showed that BerEP4, epithelial membrane antigen EMA, carcinoembryonic antigen CEA, Bcl-2, CD10, CK7 were positive, AR, PAS were negative. According to the pathological examination and immunohistochemical results, a case of eccrine poroma with concurrent basal cell carcinoma was diagnosed.
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Affiliation(s)
- Xingran Shao
- Department of Dermatology, Sinopharm Dongfeng General Hospital, Hubei University of Medicine, Shiyan, Hubei, People’s Republic of China
| | - Yaqi Dong
- Department of Dermatology, Sinopharm Dongfeng General Hospital, Hubei University of Medicine, Shiyan, Hubei, People’s Republic of China
| | - Han Liu
- Department of Dermatology, Sinopharm Dongfeng General Hospital, Hubei University of Medicine, Shiyan, Hubei, People’s Republic of China
| | - Jiao Wei
- Department of Dermatology, Sinopharm Dongfeng General Hospital, Hubei University of Medicine, Shiyan, Hubei, People’s Republic of China
| | - Xiao Xiong
- Department of Dermatology, Sinopharm Dongfeng General Hospital, Hubei University of Medicine, Shiyan, Hubei, People’s Republic of China
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12
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Kervarrec T, Sohier P, Pissaloux D, de la Fouchardiere A, Cribier B, Battistella M, Macagno N. Genetics of adnexal tumors: An update. Ann Dermatol Venereol 2023; 150:202-207. [PMID: 37270318 DOI: 10.1016/j.annder.2023.03.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 03/07/2023] [Indexed: 06/05/2023]
Abstract
Cutaneous adnexal tumors form a vast heterogeneous group that include frequent entities that are mostly benign, as well as rare tumors that are occasionally malignant. In contrast to cutaneous tumors arising from the interfollicular epidermis that develop as a result of accumulation of UV-induced DNA damage (basal cell carcinoma, squamous cell carcinoma), the oncogenesis of adnexal tumors is related to a broad spectrum of genetic mechanisms (e.g., point mutation, fusion genes, viral integration, etc.). In this setting, specific and recurrent genetic alterations have been progressively reported, and these allow better classification of these entities. For certain of them, immunohistochemical tools are now available, enabling precise integrated histological and molecular diagnosis since certain entities are linked to well-defined alterations. In this context, we aim in this review to summarize the main molecular tools currently available for the classification of adnexal tumors.
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Affiliation(s)
- T Kervarrec
- CARADERM Network, Lille, France; Department of Pathology, University Hospital Center of Tours, Tours, France.
| | - P Sohier
- CARADERM Network, Lille, France; Department of Pathology, Cochin Hospital, Assistance Publique-Hôpitaux de Paris, AP-HP Centre - University of Paris Cité, Paris, France; Faculty of Medicine, University of Paris Cité, Paris, France
| | - D Pissaloux
- Department of Pathology, Centre Léon Bérard, Lyon, France
| | | | - B Cribier
- CARADERM Network, Lille, France; Dermatology Clinic, University Hospital of Strasbourg, Hôpital Civil, Strasbourg, France
| | - M Battistella
- CARADERM Network, Lille, France; Department of Pathology, Saint Louis Hospital, Assistance Publique-Hôpitaux de Paris, AP-HP Centre - Paris 7, Paris, France
| | - N Macagno
- CARADERM Network, Lille, France; Department of Pathology, AP-HM, University Hospital of la Timone, Marseille, France; University of Aix-Marseille, INSERM U1251, MMG, Marseille, France
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13
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Ehara Y, Goto H, Ozaki K, Yoshida Y. Porocarcinoma Concurrent with Psoriasis Vulgaris: The First Report. Yonago Acta Med 2023; 66:382-384. [PMID: 37621981 PMCID: PMC10444585 DOI: 10.33160/yam.2023.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 06/26/2023] [Indexed: 08/26/2023]
Abstract
Psoriasis is a common chronical inflammatory skin disease with a prevalence of 2%-4% worldwide. In contrast, porocarcinoma is a relatively rare cutaneous neoplasm and an associated localization of both lesions is rare. Here, we describe the first case of porocarcinoma in a patient with psoriasis. A 71-year-old Japanese man was referred to our clinic for evaluation of nodule within a keratotic plaque of 20-years history on his leg. Histopathological examination showed that the plaque revealed acanthosis with regular elongation of rete ridges, agranulosis and the presence of Munro microabscesses. In contrast, massive proliferation of atypical poroid cells and a few cuticular cells in the dermis were seen in the nodule. We speculated that it is likely the porocarcinoma was caused by the elevated risk of skin cancer due to chronic inflammatory process of psoriasis itself in our patient.
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Affiliation(s)
- Yuko Ehara
- Division of Dermatology, Department of Sensory and Motor Organs, School of Medicine, Faculty of Medicine, Tottori University, Yonago 683-8503, Japan
| | - Hiroyuki Goto
- Division of Dermatology, Department of Sensory and Motor Organs, School of Medicine, Faculty of Medicine, Tottori University, Yonago 683-8503, Japan
| | - Kanae Ozaki
- Department of Pathology, School of Medicine, Faculty of Medicine, Tottori University, Yonago 683-8503, Japan
| | - Yuichi Yoshida
- Division of Dermatology, Department of Sensory and Motor Organs, School of Medicine, Faculty of Medicine, Tottori University, Yonago 683-8503, Japan
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14
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Meriläinen AS, Von Willenbrand-Bäckmann M, Sihto H, Koljonen V. Eccrine Porocarcinoma: Clinical and Histopathological Study of 14 Patients with Special Emphasis on Sentinel Lymph Node Biopsy. Acta Derm Venereol 2023; 103:adv11649. [PMID: 37448211 PMCID: PMC10391535 DOI: 10.2340/actadv.v103.11649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 05/24/2023] [Indexed: 07/15/2023] Open
Abstract
Eccrine porocarcinoma is a rare skin adnexal tumour that affects elderly people. Most eccrine porocarcinomas are stage I or II according to the American Joint Committee on Cancer. The prognosis is good in early stages, but worsens when advanced. Since information on the use of sentinel lymph node biopsy in these patients is scarce, this study examined the records of all patients with eccrine porocarcinoma treated at Helsinki University Hospital during a 17-year period and focused on sentinel lymph node biopsy patients. The study identified 14 patients (9 male, 5 female). There were 2 metastases to the lymph nodes and 2 recurrences at initial referral to our institution. All primary tumours had wide local excision and 6 patients also had sentinel lymph node biopsy, of whom none had positive lymph nodes. There were no new metastases or recurrences during follow-up. Three patients died of causes other than eccrine porocarcinoma. When comparing the wide local excision only and wide local excision with sentinel lymph node biopsy groups, no parameters reached statistical significance. The decision process of the multidisciplinary tumour board meeting on whether to perform sentinel lymph node biopsy was not clear, perhaps due to the limited knowledge of eccrine porocarcinoma. Further studies and international collaboration are warranted.
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Affiliation(s)
- Anna-Stiina Meriläinen
- Department of Surgery, The Central Hospital of Tavastia Proper, Hämeenlinna and University of Helsinki, Finland.
| | | | - Harri Sihto
- Department of Pathology Helsinki University Hospital and University of Helsinki, Finland
| | - Virve Koljonen
- Department of Plastic Surgery Helsinki University Hospital and University of Helsinki, Finland
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15
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Matthiesen J, Chiu R, Do TT, Bamdad S, Lee J, Peng SK. When to sweat: A history of chemotherapy in malignant sweat gland tumors. A unique case report and literature review. Clin Case Rep 2023; 11:e7182. [PMID: 37180317 PMCID: PMC10167622 DOI: 10.1002/ccr3.7182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 01/26/2023] [Accepted: 02/13/2023] [Indexed: 05/16/2023] Open
Abstract
Sarcomatoid sweat gland carcinomas are rare among cutaneous cancers, with less than 20 cases described. A 54-year-old woman with sarcomatoid sweat gland carcinoma of the right upper extremity suffered extensive recurrence at 15 months, unresponsive to chemotherapy. There is no standard treatment or chemotherapy regimens for metastatic sweat gland carcinoma.
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Affiliation(s)
| | - R. Chiu
- Harbor UCLA Medical CenterTorranceCaliforniaUSA
| | - T. T. Do
- Harbor UCLA Medical CenterTorranceCaliforniaUSA
| | - S. Bamdad
- Harbor UCLA Medical CenterTorranceCaliforniaUSA
| | - J. Lee
- Harbor UCLA Medical CenterTorranceCaliforniaUSA
| | - S. K. Peng
- Harbor UCLA Medical CenterTorranceCaliforniaUSA
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16
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Tsiogka A, Koumaki D, Kyriazopoulou M, Liopyris K, Stratigos A, Gregoriou S. Eccrine Porocarcinoma: A Review of the Literature. Diagnostics (Basel) 2023; 13:diagnostics13081431. [PMID: 37189532 DOI: 10.3390/diagnostics13081431] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 04/12/2023] [Accepted: 04/14/2023] [Indexed: 05/17/2023] Open
Abstract
Eccrine porocarcinoma (EPC) constitutes a rare malignant adnexal tumor, which accounts for about 0.005-0.01% of all cutaneous malignancies. It may develop de novo or arise from an eccrine poroma, after a latency period of years or even decades. Accumulating data suggest that specific oncogenic drivers and signaling pathways may be implicated in its tumorigenesis, while recent data have demonstrated a high overall mutation rate attributed to UV exposure. Diagnosis may be challenging and should rely on the combination of clinical, dermoscopical, histopathological and immunohistochemical findings. The literature is controversial regarding tumor behavior and prognosis and, therefore, there is no consensus on its surgical management, utility of lymph-node biopsy and further adjuvant or systemic treatment. However, recent advances in tumorigenesis of EPC may aid in the development of novel treatment strategies, which could improve survival of advanced or metastatic disease, such as immunotherapy. This review presents an update of the epidemiology, pathogenesis and clinical presentation of EPC and summarizes current data on diagnostic evaluation and management of this rare cutaneous malignancy.
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Affiliation(s)
- Aikaterini Tsiogka
- 1st Department of Dermatology-Venereology, Faculty of Medicine, National and Kapodistrian University of Athens, Andreas Sygros Hospital, 16121 Athens, Greece
| | - Dimitra Koumaki
- Department of Dermatology, University Hospital of Heraklion, 71500 Heraklion, Greece
| | - Maria Kyriazopoulou
- Department of Dermatology and Venereology, 401 General Military Hospital of Athens, 11525 Athens, Greece
| | - Konstantinos Liopyris
- 1st Department of Dermatology-Venereology, Faculty of Medicine, National and Kapodistrian University of Athens, Andreas Sygros Hospital, 16121 Athens, Greece
| | - Alexander Stratigos
- 1st Department of Dermatology-Venereology, Faculty of Medicine, National and Kapodistrian University of Athens, Andreas Sygros Hospital, 16121 Athens, Greece
| | - Stamatios Gregoriou
- 1st Department of Dermatology-Venereology, Faculty of Medicine, National and Kapodistrian University of Athens, Andreas Sygros Hospital, 16121 Athens, Greece
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17
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Winn RT, Gazzani P, Venables ZC, Shah F, Gkini M, Jeetle S, Oliphant T, Wijesuriya N, Martin-Clavijo A, Husain A, Harwood CA, Rajan N. Variation in management of porocarcinoma: a 10-year retrospective review of 75 cases across three UK tertiary centres. Clin Exp Dermatol 2023; 48:121-124. [PMID: 36730509 DOI: 10.1093/ced/llac052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Affiliation(s)
- R T Winn
- Departments of Dermatology and Histopathology, Royal Victoria Infirmary, Newcastle upon Tyne, UK
| | - P Gazzani
- Departments of Pathology, University Hospitals Birmingham, UK.,Department of Dermatology, Norfolk and Norwich University Hospital, Norwich, UK
| | - Z C Venables
- Norwich Medical School, University of East Anglia, Norwich, UK.,National Disease Registration Service and NHS Digital, Leeds, UK.,Centre for Cell Biology and Cutaneous Research, Blizard Institute, Queen Mary University of London, London, UK
| | - F Shah
- Departments of Pathology, University Hospitals Birmingham, UK
| | - M Gkini
- Departments of Dermatology and Pathology, Royal London Hospital, Barts Health NHS Trust, London, UK.,Departments of Pathology, Royal London Hospital, Barts Health NHS Trust, London, UK
| | - S Jeetle
- Departments of Histopathology, Royal Victoria Infirmary, Newcastle upon Tyne, UK
| | - T Oliphant
- Departments of Dermatology and Histopathology, Royal Victoria Infirmary, Newcastle upon Tyne, UK
| | - N Wijesuriya
- Departments of Pathology, Royal London Hospital, Barts Health NHS Trust, London, UK
| | | | - A Husain
- Departments of Histopathology, Royal Victoria Infirmary, Newcastle upon Tyne, UK
| | - C A Harwood
- Centre for Cell Biology and Cutaneous Research, Blizard Institute, Queen Mary University of London, London, UK.,Departments of Dermatology and Pathology, Royal London Hospital, Barts Health NHS Trust, London, UK
| | - N Rajan
- Departments of Dermatology and Histopathology, Royal Victoria Infirmary, Newcastle upon Tyne, UK.,Departments of Dermatology and Pathology, University Hospitals Birmingham, UK.,Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK
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18
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[Translated article] Poroma: A Retrospective Series of 80 Patients at a Tertiary Care Hospital. ACTAS DERMO-SIFILIOGRAFICAS 2023; 114:T102-T107. [PMID: 36462669 DOI: 10.1016/j.ad.2022.07.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 07/14/2022] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND Poroma is a benign, exclusively cutaneous, adnexal tumor with a predilection for palmoplantar skin. OBJECTIVE To analyze the clinical characteristics of poroma in our population. MATERIAL AND METHODS Retrospective study of patients diagnosed with poroma between 2002 and 2021. We conducted a chart review to record age; sex; number, location, and diameter of lesions; time since onset; clinical characteristics; suspected clinical diagnosis; resection margin status; recurrences; and follow-up duration. Categorical variables were compared using the Fisher exact test. Continuous variables were compared using the t test or the Mann-Whitney U test depending on whether they were normally or nonnormally distributed. RESULTS We studied 80 patients (31 women and 49 men) with a median (interquartile range [IQR]) age of 65.5 (29) years. Median time since onset of poroma was 12 (21) months. Median lesion diameter was 8 (7)mm, and none of the patients had multiple lesions. The lesions were located on the head and neck in 13 cases, the trunk in 13, the upper extremities in 11, and the lower extremities in 43. Twenty-three lesions (28.8%) were located at acral sites (5 on the palms and 18 on the soles). Women were more likely to have scalp lesions (P=.041). Acral lesions were more likely to be erythematous (P=.014). Five patients experienced local recurrence. CONCLUSIONS Although poromas are particularly common in acral locations (especially the feet), most of the lesions in our series (71.3%) were located elsewhere. Acral lesions were more likely to show the classic clinical features of erythema and exophytic growth.
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19
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Moreno-Vílchez C, Torrecilla-Vall-Llossera C, Llobera-Ris C, Muntaner-Virgili C, Penín RM, Marcoval J. Poroma: A Retrospective Series of 80 Patients at a Tertiary Care Hospital. ACTAS DERMO-SIFILIOGRAFICAS 2023; 114:102-107. [PMID: 35963326 DOI: 10.1016/j.ad.2022.07.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 07/12/2022] [Accepted: 07/14/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Poroma is a benign, exclusively cutaneous, adnexal tumor with a predilection for palmoplantar skin. OBJECTIVE To analyze the clinical characteristics of poroma in our population. MATERIAL AND METHODS Retrospective study of patients diagnosed with poroma between 2002 and 2021. We conducted a chart review to record age; sex; number, location, and diameter of lesions; time since onset; clinical characteristics; suspected clinical diagnosis; resection margin status; recurrences; and follow-up duration. Categorical variables were compared using the Fisher exact test. Continuous variables were compared using the t test or the Mann-Whitney U test depending on whether they were normally or nonnormally distributed. RESULTS We studied 80 patients (31 women and 49 men) with a median (interquartile range [IQR]) age of 65.5 (29) years. Median time since onset of poroma was 12 (21) months. Median lesion diameter was 8(7)mm, and none of the patients had multiple lesions. The lesions were located on the head and neck in 13 cases, the trunk in 13, the upper extremities in 11, and the lower extremities in 43. Twenty-three lesions (28.8%) were located at acral sites (5 on the palms and 18 on the soles). Women were more likely to have scalp lesions (P=.041). Acral lesions were more likely to be erythematous (P=.014). Five patients experienced local recurrence. CONCLUSIONS Although poromas are particularly common in acral locations (especially the feet), most of the lesions in our series (71.3%) were located elsewhere. Acral lesions were more likely to show the classic clinical features of erythema and exophytic growth.
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Affiliation(s)
- C Moreno-Vílchez
- Servicio de Dermatología, Hospital Universitari de Bellvitge, Barcelona, España
| | | | - C Llobera-Ris
- Servicio de Dermatología, Hospital Universitari de Bellvitge, Barcelona, España
| | - C Muntaner-Virgili
- Servicio de Dermatología, Hospital Universitari de Bellvitge, Barcelona, España
| | - R M Penín
- Servicio de Anatomía Patológica, Hospital Universitari de Bellvitge, Barcelona, España
| | - J Marcoval
- Servicio de Dermatología, Hospital Universitari de Bellvitge, Barcelona, España.
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20
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Abalaka SE, Thomas BA, Audu Z, Ejeh SA, Sani NA, Tenuche OZ, Idoko IS, Saleh A, Ubah SA. A case of racemiform trichoblastoma in a dog. J Immunoassay Immunochem 2023; 44:90-102. [PMID: 36318021 DOI: 10.1080/15321819.2022.2137809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Trichoblastoma, which is common in dogs, is now occurring with other cellular changes outside the recognized forms to warrant their continuous evaluation for proper elucidation even as their causes largely remain unknown. A case at hand involved a 9-year-old Caucasian dog, which weighed 35 kg with chief complaint of a progressive bleeding mass on the scalp. The dog had an up-to-date vaccination record and all vital parameters were within optimum ranges. The surgical excision of the firm, solitary, and alopecic mass with traumatized upper surface revealed the presence of a well-demarcated and unencapsulated mass composed of grapes-like nests of basaloid epithelial cells within follicular stroma devoid of stromal necrosis, inflammatory cellular infiltration, and neoplastic epidermal connection. However, there was tissue necrosis, hemorrhages, and inflammatory cellular infiltrates on the exposed upper part of the traumatized growth. Immunohistochemical analysis showed positive reactivity to AE1/AE3, CK5/6, and p63 but negative immunoreactivity to CK7, CK20, CEA, and TTF-1. The histomorphological and immunohistochemical evaluation of the mass on the scalp of the dog suggested a solitary racemiform trichoblastoma with a traumatized exposed upper part despite basal cell carcinoma mimicry where histological diagnosis currently hold sway over immunohistochemical evaluation.
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Affiliation(s)
| | | | - Zakariya Audu
- Department of Animal Health and Production, University of Abuja, Abuja, Nigeria
| | - Sunday Augustine Ejeh
- Department of Veterinary Physiology and Biochemistry, University of Abuja, Abuja, Nigeria
| | | | | | | | - Ahmadu Saleh
- Department of Veterinary Pathology, Ahmadu Bello University, Zaria, Nigeria
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21
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An Unusual Case of a Scrotal Porocarcinoma and Review of the Literature. Am J Dermatopathol 2023; 45:51-55. [PMID: 36484607 DOI: 10.1097/dad.0000000000002327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
ABSTRACT Porocarcinomas are rare tumors derived from the acrosyringium and eccrine ducts, which most commonly occur on the lower extremities or head and neck region in older adults. Microscopically, they invariably demonstrate continuity with the epithelium, showing downgrowth of broad anastomosing bands with more infiltrative intradermal cords and nests of pleomorphic tumor cells with ductal lumina; an associated poroma may also be seen. We report an unusual case of a porocarcinoma arising on the scrotum of a 55-year-old man. Because of the extraordinary location and the presence of keratinizing squamous differentiation, distinction from a squamous cell carcinoma was particularly challenging. Close examination revealed the presence of a co-existing poroma, and immunohistochemistry revealed loss of YAP1 with diffuse nuclear expression of NUT in both the porocarcinoma and poroma components. This finding is particularly suggestive of a YAP1::NUTM1 fusion which has been reported to be highly specific for poroid neoplasms. Distinction of porocarcinoma from its mimics is important due to the frequent aggressive behavior of this neoplasm.
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22
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Krishna S, Ravina M, Kumar A, Dasgupta S, Kote R. 18F Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography Findings in a Case of Metastatic Eccrine Porocarcinoma - An Extremely Rare Malignant Adnexal Tumor. Indian J Nucl Med 2023; 38:89-90. [PMID: 37180188 PMCID: PMC10171768 DOI: 10.4103/ijnm.ijnm_140_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2022] [Accepted: 09/22/2022] [Indexed: 02/25/2023] Open
Abstract
Porocarcinoma is a rare malignant neoplasm of eccrine sweat glands representing 0.005 to 0.1% of all cutaneous tumors. As eccrine porocarcinoma carries a high risk of recurrence and metastases, early diagnosis and management are crucial to lower mortality rate. We present the case of porocarcinoma in a 69-years-old woman who underwent 18F-fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) for staging the disease. PET/CT showed metabolically active multiple cutaneous lesions and also picked up lymph nodal and distant metastases to lungs and breast accurately. PET/CT is useful for accurate staging of the disease and for treatment planning.
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Affiliation(s)
- Sarin Krishna
- Department of Nuclear Medicine, AII India Institute of Medical Sciences, Raipur, Chhattisgarh, India
| | - Mudalsha Ravina
- Department of Nuclear Medicine, AII India Institute of Medical Sciences, Raipur, Chhattisgarh, India
| | - Amit Kumar
- Department of Medical Oncology, AII India Institute of Medical Sciences, Raipur, Chhattisgarh, India
| | - Subhajit Dasgupta
- Department of Nuclear Medicine, AII India Institute of Medical Sciences, Raipur, Chhattisgarh, India
| | - Rutuja Kote
- Department of Nuclear Medicine, AII India Institute of Medical Sciences, Raipur, Chhattisgarh, India
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Adnexal and Sebaceous Carcinomas. Dermatol Clin 2022; 41:117-132. [DOI: 10.1016/j.det.2022.07.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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24
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Intraabdominal dissemination of porocarcinoma; A case report. Int J Surg Case Rep 2022; 98:107529. [PMID: 36027829 PMCID: PMC9424600 DOI: 10.1016/j.ijscr.2022.107529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 08/15/2022] [Accepted: 08/18/2022] [Indexed: 11/24/2022] Open
Abstract
Introduction Porocarcinoma is a rare malignancy of dermal sweat glands commonly diagnosed in the seventh decade of life. It frequently evolves from a de novo benign poroma. These tumors present as a mass/nodule, ulcer, papule, or wart. Difficult to differentiate from other cutaneous lesions. Intraperitoneal invasion is scantly reported in the literature. Case presentation The authors present a case of a fifty-year-old female patient with a rare cancer of the dermal sweat glands in an unusual location and infiltration into the abdominal cavity, leading to intraperitoneal seedlings. Discussion Tumors of the sweat gland are rare and difficult to diagnose, often misdiagnosed as granuloma, squamous cell tumors, or warts. Surgical excision and Mohs micrographic surgery are mainstay treatment modalities in the early stages. Our patient was managed elsewhere with a diagnosis of granuloma. She was referred with a recurrence of the abdominal lesion. An appropriate diagnosis of porocarcinoma was made while she had an extensive intraperitoneal invasion and seedlings. We postulate that the previous abdominal incision had disseminated porocarcinoma cells into the abdominal cavity, causing extensive intraperitoneal dissemination. Conclusion Because it is rare and difficult to diagnose, there is a considerable knowledge gap in the early accurate diagnosis and appropriate management of porocarcinoma. This causes a delay in establishing a diagnosis and profoundly impacts treatment outcomes. Eccrine porocarcinoma is a rare diagnosis of cutaneous malignancy. Early diagnosis and appropriate surgical treatment are the cornerstones of improving survival. It is often misdiagnosed as granuloma, squamous cell carcinoma, or viral warts.
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25
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Ghaffari MAZ, Saleem F, Zahoor F, Batool S, Ismail U, Usman M, Saeed HFU. Hidradenocarcinoma of the Left Knee in a 55-Year-Old Woman: A Case Report. Cureus 2022; 14:e27395. [PMID: 36046298 PMCID: PMC9419465 DOI: 10.7759/cureus.27395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/28/2022] [Indexed: 11/05/2022] Open
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26
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Li YX, Gudi M, Yan Z. Primary Eccrine Porocarcinoma of the Breast: A Case Report and Review of Literature. Case Rep Oncol Med 2022; 2022:4042298. [PMID: 35685061 PMCID: PMC9173910 DOI: 10.1155/2022/4042298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 04/04/2022] [Accepted: 05/06/2022] [Indexed: 11/18/2022] Open
Abstract
Eccrine porocarcinoma (EPC) is a rare cutaneous neoplasm, with less than 500 reported cases worldwide since it was first described in 1963. EPC tends to affect the elderly and most commonly affects the head and neck. The mainstay of EPC treatment is surgery, with lymphadenectomy in the case of nodal involvement or presence of unfavourable characteristics. No evidence exists to guide the use of adjuvant chemotherapy or radiation. EPC is prone to misdiagnosis given its multiple clinical and histopathological mimics, especially in uncommon sites of presentation such as the breast. Herein, we report the case of a 59-year-old woman who presented with a left breast skin lump. The biopsied specimen revealed an infiltrative carcinoma involving the dermis and epidermis with positive IHC staining for P63 and CK5/6 and negative staining for ER, PR, and HER2. The tumour was resected and diagnosed as EPC with atypical features as overlapping characteristics of squamous cell carcinoma (SCC) were detected on histopathological analysis. In our case, a simple mastectomy with broad margins and axillary lymph node dissection with adjuvant radiotherapy to a dose of 60 Gy failed to achieve loco-regional control with nodal recurrence occurring 4 months postsurgery-a testament to the aggressive course of this rare malignancy.
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Affiliation(s)
| | - Mihir Gudi
- Department of Pathology and Laboratory Medicine, KK Women's and Children's Hospital, Singapore
| | - Zhiyan Yan
- Breast Department, KK Women's and Children's Hospital, Singapore
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27
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Signorelli C, Zanella‐Cavallero L, Ranucci V, Pellicciotti A, Ruggeri EM. Porocarcinoma of the left arm: A report of a rare skin cancer case and literature review. Clin Case Rep 2022; 10:e05721. [PMID: 35441031 PMCID: PMC9010957 DOI: 10.1002/ccr3.5721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Revised: 03/12/2022] [Accepted: 03/28/2022] [Indexed: 11/07/2022] Open
Abstract
Porocarcinoma is a rare type of skin cancer that develops from the intraepidermal ductal part of eccrine sweat glands. It can arise de novo or from poroma ground with high potential for locoregional metastatic spread, morbidity, and mortality. It mostly occurs in elderly patients.
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Affiliation(s)
- Carlo Signorelli
- Medical Oncology Unit Belcolle Hospital ASL Viterbo Viterbo Italy
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28
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Saternus R, Vogt T. Maligne Adnextumoren der Haut. AKTUELLE DERMATOLOGIE 2022. [DOI: 10.1055/a-1774-9678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
ZusammenfassungNeoplasien der Hautadnexe (benigne oder maligne) können zum einen von den Talgdrüsen oder Haarfollikel ausgehen, zum andern auch eine Differenzierung Richtung ekkriner oder apokriner Schweißdrüsen zeigen. Auch Mischformen können vorkommen. Maligne Adnextumoren entstehen i. d. R. de novo. Dennoch ist auch die maligne Entartung einer vorbestehenden benignen Läsion möglich.Maligne Adnextumoren der Haut sind im Vergleich zu anderen nicht-melanozytären Hauttumoren insgesamt eine eher seltene Entität. Jedoch zeigt sich, dass die Inzidenz von malignen Adnextumoren in den letzten Jahren zugenommen hat. Ähnlich wie bei anderen Hautkrebsarten sind auch bei malignen Adnextumoren das Alter, UV-Strahlung und Immunsuppression wichtige Risikofaktoren der Tumorgenese.Da sich die Klinik sowohl von malignen als auch benignen Adnextumoren mit Ausnahme des Morbus Paget oftmals ähneln kann und wenig spezifisch ist, kommt der Histopathologie für die korrekte Diagnosestellung eine entscheidende Bedeutung zu.Gemäß der Literatur sind die häufigsten malignen Adnextumore das Talgdrüsenkarzinom (23 %), der extramammäre Morbus Paget (19 %), das Hidradenokarzinom (15 %), das Porokarzinom (7 %) sowie das mikrozystische Adnexkarzinom (MAC) (5 %). Während manche Vertreter prognostisch mit einem Basalzellkarzinom vergleichbar sind (MAC), sind andere durchaus metastasierungsfähig vergleichbar den Plattenepithelkarzinomen (Talgdrüsenkarzinom, Porokarzinom). Andere Vertreter heben sich hier prognostisch besonders negativ ab mit hoher Lokalrezidivquote und Metastasierung, z. B. das Hidradenokarzinom.Dieser Übersichtsartikel fokussiert sich auf diese 5 relativ häufigen Adnex-Malignome, die prognostisch auch die gegebene Streubreite wiedergeben und die Erfordernis einer den jeweiligen Besonderheiten geschuldeten klinischen Versorgung und Nachbetreuung unterstreichen.
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Affiliation(s)
- Roman Saternus
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum des Saarlandes, Kirrberger Straße, D-66421 Homburg/Saar
| | - Thomas Vogt
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum des Saarlandes, Kirrberger Straße, D-66421 Homburg/Saar
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29
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Head and Neck Porocarcinoma: SEER Analysis of Epidemiology and Survival. J Clin Med 2022; 11:jcm11082185. [PMID: 35456278 PMCID: PMC9024621 DOI: 10.3390/jcm11082185] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 04/03/2022] [Accepted: 04/11/2022] [Indexed: 12/19/2022] Open
Abstract
Porocarcinoma is a rare malignant adnexal tumor. Little is known about the location of the disease in the head and neck. Our aim is to offer the largest analysis of demographic, pathological, and treatment patterns of head and neck porocarcinoma in comparison with other locations of the neoplasm from an epidemiologically representative cohort. Method: The Surveillance, Epidemiology, and End Results program of the National Cancer Institute was searched for all cases of porocarcinomas diagnosed between 2000 and 2018. This database is considered representative of the US population. Demographic, pathological, and treatment variables were compared between the head and neck and other regions. Overall and disease-specific survival was calculated and compared between groups. Results: 563 porocarcinomas were identified, with 172 in the head and neck. The mean age was 66.4 years. Males were more affected in the head and neck. Regional and distant invasion rates were low (2.9 and 2.3%, respectively). Local excision and Mohs surgery were the most frequent therapies. Five-year overall survival was 74.8%. Five-year disease-specific survival was 97%. Conclusions: Head and neck porocarcinoma affects more males than females. Regional or distant metastatic rates are low and overestimated in previous literature. Disease-specific mortality is low. Surgery remains the mainstay of treatment.
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30
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UV-induced local immunosuppression in the tumour microenvironment of eccrine porocarcinoma and poroma. Sci Rep 2022; 12:5529. [PMID: 35365704 PMCID: PMC8976087 DOI: 10.1038/s41598-022-09490-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Accepted: 03/23/2022] [Indexed: 11/10/2022] Open
Abstract
Eccrine porocarcinoma (EPC) is a rare malignant adnexal tumour of the skin. Part of EPCs develop from their benign counterpart, poroma (EP), with chronic light exposure and immunosuppression hypothesized to play a role in the malignant transformation. However, the impact of chronic light exposure on the microenvironment of EPCs and EPs has not been investigated yet. Although the clinical relevance of tumour infiltrating lymphocytes (TILs) and tertiary lymphoid structures (TLSs) has been established in various tumours, their distribution and significance in EPCs and EPs is still poorly understood. We characterized the distribution of TILs and TLSs using CD3, CD4, CD8, CD20 immunohistochemistry in a cohort of 10 EPCs and 49 EPs. We then classified our samples using solar-elastosis grading, analyzing the influence of ultraviolet (UV) damage on TIL density. A negative correlation between UV damage and TIL density was observed (CD4 r = −0.286, p = 0.04. CD8 r = −0.305, p = 0.033). No significant difference in TIL density was found between EPCs and EPs. TLS was scarse with the presence rate 10% in EPCs and 8.3% in EPs. The results suggest that UV has an immunosuppressive effect on the microenvironment of EPCs and EPs.
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31
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De Giorgi V, Silvestri F, Savarese I, Venturi F, Scarfì F, Trane L, Bellerba F, Zuccaro B, Maio V, Massi D, Gandini S. Porocarcinoma: an epidemiological, clinical, and dermoscopic 20-year study. Int J Dermatol 2022; 61:1098-1105. [PMID: 35229289 DOI: 10.1111/ijd.16129] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 01/09/2022] [Accepted: 01/11/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND Porocarcinoma (PC) is a rare cutaneous adnexal tumor with a variable metastatic potential. Given the paucity of data, guidelines and specific recommendations for PC are not yet well-established. In this study, we evaluate the disease-specific characteristics and outcome of this rare and often underestimated tumor. MATERIALS AND METHOD A retrospective study of the epidemiological, clinical, and dermoscopic characteristics among cases of histopathologically diagnosed PC, collected from the database of two skin cancer clinics in Italy (Firenze, Pistoia) from 2000 to 2020, was conducted. RESULTS Among the 52 patients with 53 tumors, 31 were men (59.6%) and 21 were women (40.4%) with an age range of 49-96 years (median age 82 years). The most common locations were the head/neck region in men (34% in men vs. 17% in women) and the lower limb in women (17% in women vs. 9% in men). Forty-eight cases (91%) underwent local excision. Of these patients, two (4%) experienced local recurrence, and one (2%) developed a second PC on a different anatomical site 1 month after the primary tumor's excision. Lymph node metastases were present in three cases (6%). Two of them have been treated surgically with adjuvant radiotherapy (both are disease-free after a 2-year follow-up period), whereas the third case developed visceral metastases followed by PC-related death. CONCLUSIONS This study, with 52 patients with 53 tumors covering a follow-up period of more than 5 years, shows a less aggressive behavior of PC with 4% local recurrence, 6% nodal metastases, and 2% mortality.
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Affiliation(s)
- Vincenzo De Giorgi
- Section of Dermatology, Department of Health Sciences, University of Florence, Florence, Italy
| | - Flavia Silvestri
- Section of Dermatology, Department of Health Sciences, University of Florence, Florence, Italy
| | - Imma Savarese
- Unit of Dermatology, S. Jacopo Hospital, AUSL Toscana Centro, Pistoia, Italy
| | - Federico Venturi
- Section of Dermatology, Department of Health Sciences, University of Florence, Florence, Italy
| | - Federica Scarfì
- Section of Dermatology, Department of Health Sciences, University of Florence, Florence, Italy
| | - Luciana Trane
- Cancer Research "AttiliaPofferi" Foundation, Pistoia, Italy
| | - Federica Bellerba
- Department of Experimental Oncology, European Institute of Oncology (IEO), IRCCS, Milan, Italy
| | - Biancamaria Zuccaro
- Section of Dermatology, Department of Health Sciences, University of Florence, Florence, Italy
| | - Vincenza Maio
- Histopathology and Molecular Diagnostics, Careggi University Hospital, Florence, Italy
| | - Daniela Massi
- Section of Pathology, Department of Health Sciences, University of Florence and Histopathology and Molecular Diagnostics, Careggi University Hospital, Florence, Italy
| | - Sara Gandini
- Department of Experimental Oncology, European Institute of Oncology (IEO), IRCCS, Milan, Italy
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32
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Treatment of Malignant Adnexal Tumors of the Skin: A 12-Year Perspective. Cancers (Basel) 2022; 14:cancers14040998. [PMID: 35205753 PMCID: PMC8870474 DOI: 10.3390/cancers14040998] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 02/11/2022] [Accepted: 02/14/2022] [Indexed: 01/25/2023] Open
Abstract
Malignant adnexal cancers of the skin—extremely rare neoplasms—are mostly reported as non-symptomatic, slow-growing nodules. These carcinomas occur mainly in the middle-aged (50–60 years of age); they are mostly localized on the upper part of the body and are locally aggressive, infiltrate surrounding tissue, and metastasize to regional lymph nodes. The patients’ outcomes depend on multiple prognostic factors, including the size of the primary tumor and its mitotic count. Surgical resection of the primary tumor with or without regional lymph nodes is the treatment method of choice; however, due to aggressive tumor behavior, perioperative treatment may be considered. The role and efficacy of radiotherapy in the treatment of skin adnexal malignancies are not yet fully defined. Some authors suggest that adjuvant radiotherapy may be considered in locally advanced and regional disease. The aim of this study was to evaluate treatment outcomes and assess the efficacy of combined therapy in patients with adnexal malignancies. Our analysis covered all cases of cutaneous adnexal tumor patients diagnosed and provided with multidisciplinary treatment with surgery and radiotherapy since the beginning of 2009.
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33
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Agaimy A. Fusion‐positive Skin/Adnexal Carcinomas. Genes Chromosomes Cancer 2022; 61:274-284. [DOI: 10.1002/gcc.23031] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 01/27/2022] [Accepted: 02/01/2022] [Indexed: 11/06/2022] Open
Affiliation(s)
- Abbas Agaimy
- Pathologisches Institut Universitätsklinikum Erlangen, Krankenhausstrasse 8‐10, 91054 Erlangen Germany
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34
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Joshy J, Mistry K, Levell NJ, van Bodegraven B, Vernon S, Rajan N, Craig P, Venables ZC. Porocarcinoma - a review. Clin Exp Dermatol 2022; 47:1030-1035. [PMID: 35149987 DOI: 10.1111/ced.15126] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 02/07/2022] [Indexed: 11/30/2022]
Abstract
From the first report in 1969 to the present day, diagnosis of eccrine porocarcinoma, also known simply as porocarcinoma (PC), remains a challenge. This review presents a concise update of the history, pathogenesis, epidemiology, diagnosis, management and prognosis of this rare sweat gland neoplasm. It differentiates towards the intraepidermal spiral ducts in the eccrine gland, is more common in those over 60 years and often affects the head, neck and lower extremities. PC presents as a dome shaped papule, plaque or nodule growing over weeks to months. The exact incidence is unknown but appears to be rising. Diagnosis is difficult because of variable presentations and similar clinical and histological features to cutaneous squamous cell carcinoma. Management involves removal of the tumour, usually using wide local excision or Mohs micrographic surgery. Prognosis is poor with PC recurring after surgery in 35%. Given the lack of standardised protocols and risk profiles, further studies would help better the understanding of PC.
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Affiliation(s)
- Jilse Joshy
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - Khaylen Mistry
- Norwich Medical School, University of East Anglia, Norwich, UK.,Department of Dermatology, Norfolk and Norwich University Hospital, Norwich, UK
| | - Nick J Levell
- Norwich Medical School, University of East Anglia, Norwich, UK.,Department of Dermatology, Norfolk and Norwich University Hospital, Norwich, UK
| | - Birgitta van Bodegraven
- British Association of Dermatologists, London, UK.,National Disease Registration Service, NHS Digital (NHSD), Leeds, UK
| | - Sally Vernon
- National Disease Registration Service, NHS Digital (NHSD), Leeds, UK
| | - Neil Rajan
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne
| | - Paul Craig
- Department of Cellular Pathology, Gloucestershire, Hospitals NHS Foundation Trust, Cheltenham, UK
| | - Zoe C Venables
- Norwich Medical School, University of East Anglia, Norwich, UK.,Department of Dermatology, Norfolk and Norwich University Hospital, Norwich, UK.,National Disease Registration Service, NHS Digital (NHSD), Leeds, UK
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35
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Supekar B, Tomar S, Bhushan R, Mukhi J, Singh R, Bhat D, Jaiswal A. Eccrine porocarcinoma at unusual location. JOURNAL OF DERMATOLOGY & DERMATOLOGIC SURGERY 2022. [DOI: 10.4103/jdds.jdds_40_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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36
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Plotzke JM, Adams DJ, Harms PW. Molecular pathology of skin adnexal tumours. Histopathology 2022; 80:166-183. [PMID: 34197659 DOI: 10.1111/his.14441] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 06/30/2021] [Indexed: 11/28/2022]
Abstract
AIMS Tumours of the cutaneous adnexa arise from, or differentiate towards, structures in normal skin such as hair follicles, sweat ducts/glands, sebaceous glands or a combination of these elements. This class of neoplasms includes benign tumours and highly aggressive carcinomas. Adnexal tumours often present as solitary sporadic lesions, but can herald the presence of an inherited tumour syndrome such as Muir-Torre syndrome, Cowden syndrome or CYLD cutaneous syndrome. In contrast to squamous cell carcinoma and basal cell carcinoma, molecular changes in adnexal neoplasia have been poorly characterised and there are few published reviews on the current state of knowledge. METHODS AND RESULTS We reviewed findings in peer-reviewed literature on molecular investigations of cutaneous adnexal tumours published to June 2021. CONCLUSIONS Recent discoveries have revealed diverse oncogenic drivers and tumour suppressor alterations in this class of tumours, implicating pathways including Ras/MAPK, PI3K, YAP/TAZ, beta-catenin and nuclear factor kappa B (NF-κB). These observations have identified novel markers, such as NUT for poroma and porocarcinoma and PLAG1 for mixed tumours. Here, we provide a comprehensive overview and update of the molecular findings associated with adnexal tumours of the skin.
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Affiliation(s)
- Jaclyn M Plotzke
- Department of Pathology, University of Michigan, Ann Arbor, MI, USA
| | | | - Paul W Harms
- Department of Pathology, University of Michigan, Ann Arbor, MI, USA
- Department of Dermatology, University of Michigan, Ann Arbor, MI, USA
- Rogel Cancer Center, University of Michigan, Ann Arbor, MI, USA
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Whole-exome sequencing in eccrine porocarcinoma indicates promising therapeutic strategies. Cancer Gene Ther 2022; 29:697-708. [PMID: 34045664 PMCID: PMC9209330 DOI: 10.1038/s41417-021-00347-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 04/23/2021] [Accepted: 05/10/2021] [Indexed: 02/06/2023]
Abstract
Malignant sweat gland tumours are rare, with the most common form being Eccrine porocarcinoma (EP). To investigate the mutational landscape of EP, we performed whole-exome sequencing (WES) on 14 formalin-fixed paraffin-embedded samples of matched primary EP and healthy surrounding tissue. Mutational profiling revealed a high overall median mutation rate. This was attributed to signatures of mutational processes related to ultraviolet (UV) exposure, APOBEC enzyme dysregulation, and defective homologous double-strand break repair. All of these processes cause genomic instability and are implicated in carcinogenesis. Recurrent driving somatic alterations were detected in the EP candidate drivers TP53, FAT2, CACNA1S, and KMT2D. The analyses also identified copy number alterations and recurrent gains and losses in several chromosomal regions including that containing BRCA2, as well as deleterious alterations in multiple HRR components. In accordance with this reduced or even a complete loss of BRCA2 protein expression was detected in 50% of the investigated EP tumours. Our results implicate crucial oncogenic driver pathways and suggest that defective homologous double-strand break repair and the p53 pathway are involved in EP aetiology. Targeting of the p53 axis and PARP inhibition, and/or immunotherapy may represent promising treatment strategies.
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Primary Eccrine Porocarcinoma of the Thumb With Metastasis: A Rare Case Report and Literature Review. Am J Dermatopathol 2021; 43:e285-e289. [PMID: 34797810 DOI: 10.1097/dad.0000000000002051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
ABSTRACT Eccrine porocarcinoma (EPC) is a rare malignant sweat gland tumor that accounts for approximately 0.005% of all cutaneous carcinomas. It favors the lower extremities. Only 3% of EPCs are on the hand, and only 6 cases occurring specifically on fingers have been previously documented. However, we met a patient with EPC presenting the primary lesion on the left thumb and an extensive cutaneous metastasis on the left forearm. Pathologic findings of axillary lymph nodes confirmed lymphatic metastasis.
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39
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Aniţei GM, Ioanid NŞ, Bandol G, Gafton ER, Patraşcu AM, Ferariu D, Slătineanu A, Bugean G, Scripcariu V. Porocarcinoma: a rare cause of lateral cervical tumor. Arch Clin Cases 2021; 6:53-58. [PMID: 34754909 PMCID: PMC8565700 DOI: 10.22551/2019.23.0602.10154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Porocarcinoma is a rare tumor of the eccrine sweat glands that usually disseminates to the regional lymph nodes, but it can also develop distant metastasis. Case presentation: We report the case of a 67 year-old female patient who underwent wide surgical resection of a left cervical cutaneous tumor in a primary care center, for which the histology exam of the specimen was mixed basal cell and squamous cell carcinoma. She was referred to our hospital's oncology clinic and histologic re-evaluation changed the diagnosis to eccrine porocarcinoma (EPC). Computer-tomography (CT) revealed cervical lymphadenopathies for which the patient underwent 4 cycles of chemotherapy, without regression. She subsequently underwent a left upper anterior jugular lymphadenectomy (group IIa) with all nodes being negative and, three months later, she developed a unique adenopathy under the parotid gland that was excised and confirmed to be metastatic. Postoperative external radiotherapy was administered with a good outcome on CT scan. Nine months after her last surgery, the patient did not show any sign of recurrence or distant metastasis. Conclusion: EPC is a challenge, both diagnostically and therapeutically. In the absence of consensus regarding the indications and extent of lymphadenectomy and adjuvant therapy, patients with EPC should be referred to an experienced multidisciplinary team in a tertiary center.
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Affiliation(s)
- Gabriela Maria Aniţei
- "Grigore T. Popa" University of Medicine and Pharmacy, Iasi, Romania.,1 Surgical Oncology Unit, Regional Institute of Oncology, Iasi, Romania
| | | | - Geanina Bandol
- Otolaryngology Department, 2 Surgical Oncology Clinic, Regional Institute of Oncology, Iasi, Romania
| | | | | | - Dan Ferariu
- Pathology Department, Regional Institute of Oncology, Iasi, Romania
| | | | - Gema Bugean
- Radiotherapy Department, Regional Institute of Oncology, Iasi, Romania
| | - Viorel Scripcariu
- "Grigore T. Popa" University of Medicine and Pharmacy, Iasi, Romania.,1 Surgical Oncology Unit, Regional Institute of Oncology, Iasi, Romania
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Goto K, Ishikawa M, Hamada K, Muramatsu K, Naka M, Honma K, Sugino T. Comparison of Immunohistochemical Expression of Cytokeratin 19, c-KIT, BerEP4, GATA3, and NUTM1 Between Porocarcinoma and Squamous Cell Carcinoma. Am J Dermatopathol 2021; 43:781-787. [PMID: 33767067 DOI: 10.1097/dad.0000000000001901] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ABSTRACT Distinguishing porocarcinoma from squamous cell carcinoma (SCC) is clinically significant; however, differential diagnosis can often be challenging. This study sought to confirm the diagnostic utility of cytokeratin 19, c-KIT, BerEP4, GATA3, and NUTM1 immunohistochemistry in distinguishing porocarcinoma from SCC. Immunohistochemical analysis of cytokeratin 19, c-KIT, BerEP4, GATA3, and NUTM1 in 14 porocarcinomas and 22 SCCs was performed; the extents and intensities of expression of these markers were recorded. The statistical associations of the immunoexpression between porocarcinoma and SCC were analyzed using the Pearson χ2 test. Cytokeratin 19 was positive in 13 (92.9%) of 14 porocarcinomas, and for all the positive cases, staining was strong and evident in >20% of the tumor cells. By contrast, 9 (40.9%) of 22 SCCs expressed cytokeratin 19 (P = 0.0018), of which 6 showed extremely focal (≤10% of the tumor cells) expression. Of the 14 porocarcinomas, 11 (78.6%) cases showed c-KIT positivity, whereas only 3 of 22 SCCs (13.6%) expressed c-KIT focally (P = 0.0001). In addition, BerEP4 immunostaining differed between porocarcinomas and SCCs (57.1% vs. 9.1%, respectively; P = 0.0017). However, no significant difference between the groups was reported in terms of GATA3 expression (57.1% vs. 72.7%, respectively; P = 0.3336). NUTM1 was expressed in 4/14 (28.6%) porocarcinomas but not in the SCCs. Immunohistochemistry for cytokeratin 19, c-KIT, and BerEP4 could be helpful in distinguishing porocarcinomas from SCCs. In addition, NUTM1 immunoexpression is highly specific, although not sensitive, to porocarcinomas. GATA3 immunohistochemistry has no meaningful implications in the differential diagnosis of porocarcinoma and SCC.
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Affiliation(s)
- Keisuke Goto
- Department of Pathology, Tokyo Metropolitan Cancer and Infectious Disease Center Komagome Hospital, Tokyo, Japan
- Department of Pathology, Itabashi Central Clinical Laboratory, Tokyo, Japan
- Department of Diagnostic Pathology, Shizuoka Cancer Center Hospital, Sunto, Japan
- Department of Diagnostic Pathology and Cytology, Osaka International Cancer Institute, Osaka, Japan
- Department of Dermatology, Hyogo Cancer Center, Akashi, Japan
| | - Misawo Ishikawa
- Department of Diagnostic Pathology, Kainan Hospital, Yatomi, Japan
| | - Kengo Hamada
- Department of Dermatology, Shizuoka Cancer Center Hospital, Sunto, Japan; and
- Department of Dermatology, Nara Medical University Hospital, Kashihara, Japan
| | - Koji Muramatsu
- Department of Diagnostic Pathology, Shizuoka Cancer Center Hospital, Sunto, Japan
| | - Miho Naka
- Department of Diagnostic Pathology, Shizuoka Cancer Center Hospital, Sunto, Japan
| | - Keiichiro Honma
- Department of Diagnostic Pathology and Cytology, Osaka International Cancer Institute, Osaka, Japan
| | - Takashi Sugino
- Department of Diagnostic Pathology, Shizuoka Cancer Center Hospital, Sunto, Japan
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41
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Grieco M, Simonacci F, Grignaffini E, Ricci R, Raposio E. Eccrine porocarcinoma: case report and review of the literature. GIORN ITAL DERMAT V 2021; 155:500-504. [PMID: 33050682 DOI: 10.23736/s0392-0488.17.05182-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Eccrine porocarcinoma is a rare skin cancer that originates from the acrosyringium of eccrine sweat glands. From the clinical point of view the differential diagnosis with other skin cancers such as basal cell carcinoma and squamous cell carcinoma it is often impossible, only the histopathologic features can lead to the definitive diagnosis. Eccrine porocarcinoma can arise from a previous poroma or de novo, it may recur after surgical excision and cause lymph node and visceral metastasis. There are no international guidelines for treatment or follow-up of patients. The aim of this work was to present a rare case of eccrine porocarcinoma of the scalp successfully treated in our clinic and to extrapolate from the international literature the main clinical and histopathological features of eccrine porocarcinoma and the various experiences regarding the types of treatment.
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Affiliation(s)
- Michele Grieco
- Division of Plastic Surgery, Department of Surgical Sciences, University of Parma, Parma, Italy.,Unit of Cutaneous, Regenerative, Mininvasive and Plastic Surgery, University Hospital of Parma, Parma, Italy
| | - Francesco Simonacci
- Division of Plastic Surgery, Department of Surgical Sciences, University of Parma, Parma, Italy - .,Unit of Cutaneous, Regenerative, Mininvasive and Plastic Surgery, University Hospital of Parma, Parma, Italy
| | - Eugenio Grignaffini
- Division of Plastic Surgery, Department of Surgical Sciences, University of Parma, Parma, Italy.,Unit of Cutaneous, Regenerative, Mininvasive and Plastic Surgery, University Hospital of Parma, Parma, Italy
| | - Roberto Ricci
- Unit of Anatomic Pathology, University Hospital of Parma, Parma, Italy
| | - Edoardo Raposio
- Division of Plastic Surgery, Department of Surgical Sciences, University of Parma, Parma, Italy.,Unit of Cutaneous, Regenerative, Mininvasive and Plastic Surgery, University Hospital of Parma, Parma, Italy
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42
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Rao EM, Knackstedt TJ. A systematic review of periungual eccrine neoplasms. Int J Dermatol 2021; 61:812-820. [PMID: 34494261 DOI: 10.1111/ijd.15893] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Revised: 07/13/2021] [Accepted: 08/17/2021] [Indexed: 11/28/2022]
Abstract
Eccrine tumors are a rare cutaneous adnexal neoplasm originating from the sweat glands. The periungual region represents an uncommon localization for these neoplasms. We analyzed all published demographic, clinical, and treatment data on periungual eccrine tumors. A systematic review following PRISMA guidelines was performed of articles published prior to March 2021. Articles were included in the review if a full-text English version was available. Of the surveyed literature, 27 full-text case reports were included in the final analysis. Benign eccrine poroma and porocarcinoma were the most common tumor subtypes (nine and eight cases, respectively). Males were only affected by poroma and porocarcinoma, while females were affected by all tumor subtypes. The first toe was the most common lower extremity affected. Misdiagnosis led to delayed treatment in 25% of cases. As such, while periungual eccrine neoplasms are rare diagnoses, the nonspecific presentations of these growths raise concerns about misdiagnosis and delayed treatment. Further research is needed related to sex-differences in the epidemiology of these growths and into the prevalence of the first toe as a location. These tumors should be considered in the differential diagnosis for nail unit afflictions.
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Affiliation(s)
- Elizabeth M Rao
- Department of Dermatology, MetroHealth System, Cleveland, OH, USA
| | - Thomas J Knackstedt
- Department of Dermatology, MetroHealth System, Cleveland, OH, USA.,School of Medicine, Case Western Reserve University, Cleveland, OH, USA
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43
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Kalamkar C, Radke N, Mukherjee A, Radke S. Rare case of large eccrine poroma of the eyelid. Med J Armed Forces India 2021; 77:371-373. [PMID: 34305294 DOI: 10.1016/j.mjafi.2020.07.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2016] [Accepted: 07/28/2020] [Indexed: 10/23/2022] Open
Abstract
Eccrine poroma is a rare tumor arising from sweat glands with common location being soles and palms. We are reporting a case of 70-year male patient with large lower lid mass lesion. Owing to its location and history of growth, malignancy was suspected. Biopsy proved it to be eccrine poroma which is a benign lesion. Complete excision with lid reconstruction was done. Eccrine poroma, though rare, should be kept in the differential diagnosis of eyelid tumors. Owing to the risk of malignant transformation and difficulty in clinical differentiation between poroma and porocarcinoma, wide excision should be done.
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Affiliation(s)
- Charudutt Kalamkar
- Consultant (Anterior Segment), Shri Ganesh Vinayak Eye Hospital, Raipur, Chhattisgarh, India
| | - Nishant Radke
- Consultant (Vireo-Retina Services), Shri Ganesh Vinayak Eye Hospital, Raipur, Chhattisgarh, India
| | - Amrita Mukherjee
- Consultant (Anterior Segment), Shri Ganesh Vinayak Eye Hospital, Raipur, Chhattisgarh, India
| | - Snehal Radke
- Consultant (Anterior Segment), Shri Ganesh Vinayak Eye Hospital, Raipur, Chhattisgarh, India
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44
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Noda R, Inoue T, Tsunoda S, Segawa M, Masuda Y, Morikawa T, Akabane A. Management of brain metastasis from eccrine porocarcinoma: illustrative case. JOURNAL OF NEUROSURGERY. CASE LESSONS 2021; 1:CASE21242. [PMID: 35854905 PMCID: PMC9245753 DOI: 10.3171/case21242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 04/21/2021] [Indexed: 06/15/2023]
Abstract
BACKGROUND Eccrine porocarcinoma (EP) is a rare malignant skin neoplasm, and there are still many unknowns regarding its natural history and treatment. Due to its scarcity, associated brain metastasis is a far rarer condition. OBSERVATIONS A 71-year-old-woman with a history of EP was diagnosed with brain metastasis. In her clinical course, the patient underwent tumor removal surgery twice and Gamma Knife radiosurgery (GKRS) four times. The tumor showed a good response to radiotherapy. The histopathological findings of the brain tumor were consistent with those of the primary skin tumor. LESSONS There are only a few case reports referring to the detailed treatment, especially with GKRS, of brain metastasis from EP. Few reports have presented a detailed histopathological comparison between the primary skin lesion and the metastatic brain lesion. Herein, the authors have described the clinical course, histological features, and results of multidisciplinary treatment for brain metastasis of EP.
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Affiliation(s)
| | | | | | | | - Yoshio Masuda
- Gamma Knife Center, NTT Medical Center Tokyo, Shinagawa-ku, Tokyo, Japan
| | - Teppei Morikawa
- Gamma Knife Center, NTT Medical Center Tokyo, Shinagawa-ku, Tokyo, Japan
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45
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[Management of malignant adnexal neoplasms of the skin]. Hautarzt 2021; 72:619-632. [PMID: 34137901 DOI: 10.1007/s00105-021-04829-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/21/2021] [Indexed: 10/21/2022]
Abstract
Malignant adnexal neoplasms of the skin are a heterogeneous group of rare malignancies with eccrine, apocrine, sebaceous and follicular differentiation. Essential clinical practice recommendations for the overall management of these cancers are presented. Moreover, specific evidence-based findings according to diagnosis, therapy and follow-up of porocarcinoma, sebaceous carcinoma and microcystic adnexcarcinoma will be explained.
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46
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Hile G, Harms PW. Update on Molecular Genetic Alterations of Cutaneous Adnexal Neoplasms. Surg Pathol Clin 2021; 14:251-272. [PMID: 34023104 DOI: 10.1016/j.path.2021.03.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Cutaneous adnexal tumors recapitulate follicular, sweat gland, and/or sebaceous epithelia, and range from benign tumors to aggressive carcinomas. Adnexal tumors can be hallmarks for inherited tumor syndromes. Oncogenic drivers of adnexal neoplasms modulate intracellular pathways including mitogen-activated protein kinase, phosphoinositide-3-kinase, Wnt/β-catenin, Hedgehog, nuclear factor κB, and Hippo intracellular signaling pathways, representing potential therapeutic targets. Malignant progression can be associated with tumor suppressor loss, especially TP53. Molecular alterations drive expression of specific diagnostic markers, such as CDX2 and LEF1 in pilomatricomas/pilomatrical carcinomas, and NUT in poromas/porocarcinomas. In these ways, improved understanding of molecular alterations promises to advance diagnostic, prognostic, and therapeutic possibilities for adnexal tumors.
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Affiliation(s)
- Grace Hile
- Department of Dermatology, University of Michigan, 1910 Taubman Center, 1500 East Medical Center Drive, Ann Arbor, MI 48109-5314, USA
| | - Paul W Harms
- Department of Dermatology, University of Michigan, 1910 Taubman Center, 1500 East Medical Center Drive, Ann Arbor, MI 48109-5314, USA; Department of Pathology, University of Michigan, 2800 Plymouth Road, Building 35, Ann Arbor, MI 48109 - 2800, USA.
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47
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Current Diagnosis and Treatment Options for Cutaneous Adnexal Neoplasms with Apocrine and Eccrine Differentiation. Int J Mol Sci 2021; 22:ijms22105077. [PMID: 34064849 PMCID: PMC8151110 DOI: 10.3390/ijms22105077] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Revised: 04/15/2021] [Accepted: 05/02/2021] [Indexed: 12/16/2022] Open
Abstract
Adnexal tumors of the skin are a rare group of benign and malignant neoplasms that exhibit morphological differentiation toward one or more of the adnexal epithelium types present in normal skin. Tumors deriving from apocrine or eccrine glands are highly heterogeneous and represent various histological entities. Macroscopic and dermatoscopic features of these tumors are unspecific; therefore, a specialized pathological examination is required to correctly diagnose patients. Limited treatment guidelines of adnexal tumor cases are available; thus, therapy is still challenging. Patients should be referred to high-volume skin cancer centers to receive an appropriate multidisciplinary treatment, affecting their outcome. The purpose of this review is to summarize currently available data on pathogenesis, diagnosis, and treatment approach for apocrine and eccrine tumors.
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48
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Le HML, Faugeras L, De Moor V, Fervaille C, Vander Borght T, Collette F, D'Hondt L. Eccrine Porocarcinoma: A Challenging Diagnostic and Therapeutic Tumoral Entity. Case Rep Oncol 2021; 14:700-705. [PMID: 34177519 PMCID: PMC8215959 DOI: 10.1159/000514984] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 02/02/2021] [Indexed: 11/30/2022] Open
Abstract
Eccrine porocarcinoma is a rare malignant cutaneous tumor with high rates of extracutaneous spread, and its diagnosis and management can be quite challenging. This is a case of an 82-year-old woman presenting with an asymptomatic and chronic pubic skin lesion for whom the work-up required many investigations and procedures to confirm the diagnosis of metastatic eccrine porocarcinoma. Indeed, the patient underwent a wide local excision of the skin lesion, imaging with an FDG-PET scan, a colonoscopy, and two inguinal node dissections. As illustrated in this case, surgery should always be considered to achieve disease remission. Other treatments such as chemotherapy and radiotherapy have also been reported in the literature without clear standard guidelines.
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Affiliation(s)
- Ha Mo Linh Le
- Department of Oncology, CHU UCL Namur - Site Godinne, Yvoir, Belgium
| | - Laurence Faugeras
- Department of Oncology, CHU UCL Namur - Site Godinne, Yvoir, Belgium
| | - Véronique De Moor
- Department of General Surgery, CHU UCL Namur - Site Godinne, Yvoir, Belgium
| | | | | | - Fanny Collette
- Department of Oncology, CHU UCL Namur - Site Godinne, Yvoir, Belgium
| | - Lionel D'Hondt
- Department of Oncology, CHU UCL Namur - Site Godinne, Yvoir, Belgium
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49
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Olmos Nieva C, Samaniego González E, González Morán M, Rodríguez Prieto M. Eccrine Porocarcinoma: A Clinical and Histologic Description of a Series of 11 Cases Treated at the University Hospital Complex in Leon, Spain. ACTAS DERMO-SIFILIOGRAFICAS 2021. [DOI: 10.1016/j.adengl.2021.02.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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50
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Choi IH, Yu DS, Lee YB. A Case of Eccrine Poromatosis in a Patient with a History of Chemotherapy Due to Stomach Cancer. Ann Dermatol 2021; 32:422-425. [PMID: 33911778 PMCID: PMC7992576 DOI: 10.5021/ad.2020.32.5.422] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Revised: 10/08/2019] [Accepted: 10/10/2019] [Indexed: 11/08/2022] Open
Abstract
An eccrine poroma (EP) is a benign adnexal tumor that typically presents as a single lesion. Eccrine poromatosis defined as multiple EPs is an uncommon presentation. A 54-year-old male had undergone operation for stomach cancer 10 years prior and insisted that he had also taken adjuvant chemotherapy. The patient presented with six reddish papules and nodules scattered on the trunk and extremities for 3 years. The histopathologic findings from all six lesions were consistent with EP. No local recurrence was observed after complete removal through punch biopsies. We report a rare case of eccrine poromatosis in the patient with gastric cancer, suspected of being caused by chemotherapy.
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Affiliation(s)
- In Hye Choi
- Department of Dermatology, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Dong Soo Yu
- Department of Dermatology, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Young Bok Lee
- Department of Dermatology, College of Medicine, The Catholic University of Korea, Seoul, Korea
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