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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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2
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Kyrmanidou E, Fotiadou C, Kemanetzi C, Trakatelli MG, Trigoni A, Patsatsi A, Apalla Z, Lazaridou E. Eccrine Poroma: Pathogenesis, New Diagnostic Tools and Association with Porocarcinoma-A Review. Diagnostics (Basel) 2023; 13:2689. [PMID: 37627947 PMCID: PMC10453495 DOI: 10.3390/diagnostics13162689] [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: 07/22/2023] [Revised: 08/11/2023] [Accepted: 08/14/2023] [Indexed: 08/27/2023] Open
Abstract
Eccrine poroma (EP) is a relatively rare benign adnexal neoplasm that usually affects elderly patients. Its pathogenesis is still under investigation, but recent gene studies have revealed gene fusions as key incidences resulting in oncogenetic pathways. It often presents as a solitary, firm papule, mostly asymptomatic, located on the soles or palms. Due to its clinical and dermoscopic variability, it is characterized as the great imitator. We performed a literature review, aiming to summarize current data on the pathogenetic mechanisms, new dermoscopic features, and novel diagnostic tools that may aid in early diagnosis and proper management of this rare adnexal tumor. Furthermore, we reviewed the possible pathogenetic associations between EP and its malignant counterpart, namely eccrine porocarcinoma. This systematic approach may aid in understanding the pathogenetic mechanisms and how to use novel histopathologic markers and imaging methods to overcome the diagnostic dilemma of this rare tumor.
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Affiliation(s)
- Eirini Kyrmanidou
- 2nd Department of Dermatology, School of Medicine, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (C.F.); (C.K.); (M.-G.T.); (A.T.); (A.P.); (Z.A.); (E.L.)
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3
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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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4
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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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5
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Joshy J, van Bodegraven B, Mistry K, Craig P, Rajan N, Vernon S, Levell NJ, Venables ZC. Epidemiology of porocarcinoma in England 2013-2018: a population-based registry study. Clin Exp Dermatol 2023; 48:770-777. [PMID: 37002829 DOI: 10.1093/ced/llad122] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 03/26/2023] [Accepted: 03/27/2023] [Indexed: 07/20/2023]
Abstract
BACKGROUND Porocarcinoma (PC) is a cutaneous malignancy that differentiates towards (possibly arises from) the sweat ducts and glands. Lack of histological diagnostic markers makes clinical and pathological diagnosis complex. The limited data available suggest the incidence is increasing; however, this remains to be established in national epidemiological studies. OBJECTIVES To report the incidence, treatment and survival of patients with PC in England from 1 January 2013 to 31 December 2018 using national cancer registry data. METHODS PC diagnoses in England during 2013-2018 were identified from the National Disease Registration Service using morphology and behaviour codes. These were registered from routinely collected pathology reports and cancer outcomes and services datasets. The 2013 European age standardized incidence rates (EASRs), Kaplan-Meier all-cause survival and log-rank test were calculated. RESULTS In total, 738 tumours (396 in males and 342 in females) were diagnosed. The median age at diagnosis was 82 years old (interquartile range 74-88). The most frequently affected site were lower limbs (35.4%), followed by the face (16%). The majority of the cohort received surgical excision (73.0%). The Kaplan-Meier all-cause survival was 45.4% at 5 years, which was lower than in previous studies. The EASR for the whole population was 0.25 [95% confidence interval (CI) 0.23-0.27] per 100 000 person-years (PY)]. PC incidence rates in the East of England (EASR of 0.54, 95% CI 0.47-0.63 per 100 000 PY) were three times higher than the South West (EASR of 0.14, 95% CI 0.10-0.19 per 100 000 PY) where the regional rates were the lowest. CONCLUSIONS This study shows that there is large variation in the EASRs of PC across England. This may reflect differences in how PC is diagnosed and registered in different regions in England. These data support national assessment of the management of PC, which will inform future studies and guideline development.
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Affiliation(s)
- Jilse Joshy
- University of East Anglia, Norwich Medical School, Norwich, UK
| | - Birgitta van Bodegraven
- British Association of Dermatologists, London, UK
- National Disease Registration Service, Data and Analytics, NHS England, UK
| | - Khaylen Mistry
- University of East Anglia, Norwich Medical School, Norwich, UK
- Norfolk and Norwich University Hospitals NHS Foundation Trust, Dermatology, Norwich, UK
| | - Paul Craig
- Department of Cellular Pathology, Gloucestershire Hospitals NHS Foundation Trust, Cheltenham, UK
| | - Neil Rajan
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Sally Vernon
- National Disease Registration Service, Data and Analytics, NHS England, UK
| | - Nick J Levell
- University of East Anglia, Norwich Medical School, Norwich, UK
- Norfolk and Norwich University Hospitals NHS Foundation Trust, Dermatology, Norwich, UK
| | - Zoe C Venables
- University of East Anglia, Norwich Medical School, Norwich, UK
- National Disease Registration Service, Data and Analytics, NHS England, UK
- Norfolk and Norwich University Hospitals NHS Foundation Trust, Dermatology, Norwich, UK
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6
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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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7
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Chouhan M, Dhakar P, Solanki B, Kumari R, Gupta R. Eccrine Porocarcinoma of Dorsum of Nose: A Rare Case Report. Indian J Otolaryngol Head Neck Surg 2023; 75:1093-1095. [PMID: 37206727 PMCID: PMC10188804 DOI: 10.1007/s12070-023-03632-5] [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: 12/16/2022] [Accepted: 02/23/2023] [Indexed: 03/08/2023] Open
Abstract
Eccrine porocarcinoma (EPC) is an uncommon malignant tumor derived from the eccrine sweat glands. Because of its various pathological features, it is often confused with other malignant cutaneous tumors. We present a case of 78-year- old female having ulcerative lesion over external nasal pyramid. Biopsy suggested of squamous cell carcinoma. Tumor was excised and reconstruction was done using paramedian forehead flap. Post operative Histopathological Examination (HPE) suggested of eccrine porocarcinoma.
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Affiliation(s)
- Mahendra Chouhan
- Department of Otorhinolaryngology and Head and Neck Surgery, Dr. Sampurnanad Medical College, Jodhpur, Rajasthan 342001 India
| | - Preeti Dhakar
- Department of Otorhinolaryngology and Head and Neck Surgery, Dr. Sampurnanad Medical College, Jodhpur, Rajasthan 342001 India
| | - Bharti Solanki
- Department of Otorhinolaryngology and Head and Neck Surgery, Dr. Sampurnanad Medical College, Jodhpur, Rajasthan 342001 India
| | - Rama Kumari
- Department of Pathology, Dr. Sampurnanad Medical College, Jodhpur, Rajasthan India
| | - Ruchika Gupta
- Department of Otorhinolaryngology and Head and Neck Surgery, Dr. Sampurnanad Medical College, Jodhpur, Rajasthan 342001 India
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8
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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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9
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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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10
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Tormo-Mainar S, Vidal J, Salido M, Pujol RM, Deza G. YAP1-NUTM1 Gene Fusion in Eccrine Porocarcinoma with Late Metastatic Recurrence: A Case Report. Acta Derm Venereol 2022; 102:adv00752. [DOI: 10.2340/actadv.v102.2417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Abstract is missing (Short communication)
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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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12
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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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13
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Current Treatment Options for Cutaneous Adnexal Malignancies. Curr Treat Options Oncol 2022; 23:736-748. [DOI: 10.1007/s11864-022-00971-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/22/2022] [Indexed: 11/03/2022]
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14
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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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15
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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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16
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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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17
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Meriläinen AS, Sihto H, Koljonen V. Merkel cell polyomavirus is a passenger virus in both poroma and porocarcinoma. J Cutan Pathol 2021; 49:49-54. [PMID: 34313332 DOI: 10.1111/cup.14109] [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: 04/23/2021] [Revised: 07/14/2021] [Accepted: 07/16/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Merkel cell polyomavirus (MCPyV) has been studied in several malignant and nonmalignant tissues. However, only in Merkel cell carcinoma (MCC) has the connection to tumorigenesis been established. Previously, eccrine porocarcinoma samples were shown to express MCPyV in the majority of samples. We aimed to examine MCPyV in porocarcinoma and poroma samples using MCC as the reference material. METHODS We analyzed 17 porocarcinoma and 50 poroma samples for the presence of MCPyV using LT antigen immunostaining and DNA detection methods. In addition, 180 MCC samples served as controls. RESULTS MCPyV LT antigen immunostaining was detected in 10% of poroma and 18% of porocarcinoma samples; on the other hand, it was present in 65% of MCC samples. MCPyV DNA was detected in only 10% of poroma and porocarcinoma samples compared with 96% of MCC samples. The viral DNA copy number in all MCPyV DNA-positive MCCs was at least 25 times higher than that in porocarcinoma or poroma samples with the highest MCPyV DNA-to-PTPRG ratio. CONCLUSIONS The low number of viral DNA copies in poroma and porocarcinoma samples, together with the negative LT expression of MCPyV DNA-positive tumors, indicates that MCPyV is simply a passenger virus rather than an oncogenic driver of porocarcinoma.
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Affiliation(s)
| | - Harri Sihto
- Department of Pathology, University of Helsinki, Helsinki, Finland
| | - Virve Koljonen
- Department of Plastic Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
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18
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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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19
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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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20
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Clear Cell Differentiation in Eccrine Porocarcinoma as a High-Risk Feature: Epidemiologic and Pathologic Features of Eccrine Porocarcinoma in a Single-Center Case Series. Am J Dermatopathol 2021; 43:647-652. [PMID: 33867455 DOI: 10.1097/dad.0000000000001852] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
ABSTRACT Eccrine porocarcinoma (EPC) is a rare sweat gland malignancy. Recognition of histologic features is challenging, and specific pathologic features correlate with risk of poor outcome. This single-center retrospective review and case series of 58 EPC cases from 2000 to 2016 elucidates epidemiologic and pathologic characteristics of EPC. Pathology slides from 52 cases were analyzed by a dermatopathologist for standardized variable characteristics, including previously determined high-risk features (HRF) associated with poor prognosis. The incidence of EPC increased over the study period with 3 times more cases diagnosed in the last 4 years than in the first 4 years. Most cases were in the elderly males (mean age 75 years), and 50% were located in the head and neck region. Although 38% of tumors exhibited one histologic HRF, only 10% exhibited more than one. Of the HRF, a greater tumor depth was associated with both increased age (P = 0.04) and clear cell differentiation (P = 0.02). This study elucidates epidemiologic and pathologic features of EPC and highlights how age and clear cell differentiation can be associated with greater tumor depth, although further research is needed to determine whether clear cell differentiation is associated with poor clinical outcome.
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21
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Olmos Nieva CC, Samaniego González E, González Morán MA, Rodríguez Prieto MA. 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 2020; 112:478-481. [PMID: 33307007 DOI: 10.1016/j.ad.2020.01.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Revised: 12/08/2019] [Accepted: 01/13/2020] [Indexed: 11/18/2022] Open
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22
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Fernández-Ferreira R, Alvarado-Luna G, Motola-Kuba D, Mackinney-Novelo I, Cervera-Ceballos EE, Segura-Rivera R. Intergluteal Cleft Eccrine Porocarcinoma with Metastasis to Inguinal Region and Lung: Case Report and Review of the Literature. Case Rep Oncol 2020; 13:1463-1473. [PMID: 33442371 PMCID: PMC7772857 DOI: 10.1159/000510311] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Accepted: 07/19/2020] [Indexed: 11/21/2022] Open
Abstract
Eccrine porocarcinoma (EPC) is an infrequent cutaneous neoplasm, and was described in 1963 by Pinkus and Mehregan. It is a rare type of skin tumor (0.005-0.01% of all skin tumors). Less than 300 cases have been described in the entire world medical literature. To our knowledge, no case of intergluteal cleft EPC has been reported in the literature in English and Spanish to date, so this would be the first reported case of such pathology. Metastatic EPC is less frequent, since only <10% of metastatic type have been reported and the rest as localized disease. The primary treatment of choice is surgical wide local excision of the tumor with histological confirmation of tumor-free margins. Prognosis is difficult to determine because of the rarity of EPC and the variations in natural history. There are no data to support the use of adjuvant chemotherapy or radiotherapy, and there are currently no agreed criteria to define patients at high risk of relapse. We present a 67-year-old man with intergluteal cleft eccrine tumor by biopsy. Metastasis to left inguinal region and lung was reported by contrasted abdominal and chest computed tomography. He started chemotherapy based on etoposide, vincristine, carboplatin. A review of pertinent literature is provided.
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Affiliation(s)
- Ricardo Fernández-Ferreira
- Oncology Medicine Department, Comprehensive Oncology Center “Diana Laura Riojas de Colosio,” Medica Sur Clinic & Foundation, Mexico City, Mexico
| | - Gabriela Alvarado-Luna
- Oncology Medicine Department, Comprehensive Oncology Center “Diana Laura Riojas de Colosio,” Medica Sur Clinic & Foundation, Mexico City, Mexico
| | - Daniel Motola-Kuba
- Oncology Medicine Department, Comprehensive Oncology Center “Diana Laura Riojas de Colosio,” Medica Sur Clinic & Foundation, Mexico City, Mexico
| | - Ileana Mackinney-Novelo
- Oncology Medicine Department, Comprehensive Oncology Center “Diana Laura Riojas de Colosio,” Medica Sur Clinic & Foundation, Mexico City, Mexico
| | - Eduardo Emir Cervera-Ceballos
- Oncology Medicine Department, Comprehensive Oncology Center “Diana Laura Riojas de Colosio,” Medica Sur Clinic & Foundation, Mexico City, Mexico
| | - Román Segura-Rivera
- Service of Anatomical Pathology, Medica Sur Clinic & Foundation, Mexico City, Mexico
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23
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Modi MB, Moshiri AS, Shoji T, Mihm MC, Xu X, Elder DE. Occurrence of metastatic eccrine porocarcinoma in an immunosuppressed patient. SURGICAL AND EXPERIMENTAL PATHOLOGY 2020. [DOI: 10.1186/s42047-020-00068-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Eccrine porocarcinoma is a rare malignancy accounting for 0.005 to 0.01% of all cutaneous tumors. However, its etiology is not well established. Herein we are reporting the occurrence of metastatic porocarcinoma of the back in a patient with a history of multiple cutaneous malignancies and chronic immunosuppression.
Case presentation
A 79-year-old male with a history of long-term immunosuppressive therapy for left lung transplantation and multiple cutaneous malignancies including melanoma, presented with an enlargening plaque on the right upper back. Biopsy demonstrated an infiltrative epithelial tumor with aggressive histology and ductal formation. Immunohistochemical stains for p63, CK-5/6, and CEA were diffusely positive, while CK-7 and CK-20 were negative. A diagnosis of eccrine porocarcinoma was made. He underwent complete wide excision with negative margins of the right upper back in January 2018. In November 2018, he was found to have a right posterior shoulder mass, positive right axillary lymph nodes, superficial right upper back soft tissue masses and lymphangitic carcinomatosis involving the left lung. He was transitioned to comfort care and subsequently passed from metastatic disease in December 2018.
Conclusion
The occurrence of eccrine porocarcinoma in a patient on long term immunosuppressive therapy for lung transplantation suggests a possible role for chronic immunosuppression in the induction of a subset of eccrine porocarcinomas, as in other cutaneous malignancies.
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24
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DEREBAŞINLIOĞLU H, NEMMEZİ KARACA S. A 20-YEAR RETROSPECTIVE ANALYSIS OF SKIN CANCERS: COMPARISON OF THE FIRST AND SECOND DECADES. KONURALP TIP DERGISI 2020. [DOI: 10.18521/ktd.708364] [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]
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25
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Le NS, Janik S, Liu DT, Grasl S, Faisal M, Pammer J, Schickinger-Fischer B, Hamzavi JS, Seemann R, Erovic BM. Eccrine porocarcinoma of the head and neck: Meta-analysis of 120 cases. Head Neck 2020; 42:2644-2659. [PMID: 32314845 DOI: 10.1002/hed.26178] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Revised: 03/09/2020] [Accepted: 04/03/2020] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND The aim of the study is to analyze potential prognostic factors and to evaluate therapy strategies regarding clinical outcome in patients with eccrine porocarcinoma (EPC) of the head and neck. METHODS One hundred and sixteen EPC cases from ninety studies and four authors' EPC cases were included in the meta-analysis. RESULTS At an average follow up of 20.48 months, the 3-year overall survival and regional recurrence rate were 70.3% and 19.0%, respectively. Patients without surgical treatment had a significantly worse 3-year overall survival. Mohs microscopic surgery led to significantly less occurrence of regional recurrences compared to wide excision. An ulcerating lesion, high mitotic activity, and lymphovascular invasion were significant prognostic factors. CONCLUSION Surgical resection is the cornerstone in the therapy of EPC and represents the therapeutic modality that offers the best chance of disease-free survival. Due to the high probability of recurrence, close follow-ups are strongly recommended.
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Affiliation(s)
- Nguyen-Son Le
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Vienna, Vienna, Austria
| | - Stefan Janik
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Vienna, Vienna, Austria
| | - David T Liu
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Vienna, Vienna, Austria
| | - Stefan Grasl
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Vienna, Vienna, Austria
| | - Muhammad Faisal
- Institute of Head and Neck Diseases, Evangelical Hospital Vienna, Vienna, Austria.,Department of Surgical Oncology, Shaukat Khanum Memorial Cancer Hospital and Research Center, Lahore, Pakistan
| | - Johannes Pammer
- Department of Clinical Pathology, Medical University of Vienna, Vienna, Austria
| | | | - Jafar-Sasan Hamzavi
- Institute of Head and Neck Diseases, Evangelical Hospital Vienna, Vienna, Austria
| | - Rudolf Seemann
- Institute of Head and Neck Diseases, Evangelical Hospital Vienna, Vienna, Austria
| | - Boban M Erovic
- Institute of Head and Neck Diseases, Evangelical Hospital Vienna, Vienna, Austria
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26
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Behbahani S, Malerba S, Karanfilian KM, Warren CJ, Alhatem A, Samie FH. Demographics and outcomes of eccrine porocarcinoma: results from the National Cancer Database. Br J Dermatol 2020; 183:161-163. [PMID: 31954060 DOI: 10.1111/bjd.18874] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- S Behbahani
- Rutgers New Jersey Medical School, Newark, NJ, U.S.A
| | - S Malerba
- Rutgers New Jersey Medical School, Newark, NJ, U.S.A
| | | | - C J Warren
- Rutgers New Jersey Medical School, Newark, NJ, U.S.A
| | - A Alhatem
- Department of Pathology and Laboratory, Rutgers New Jersey Medical School, Newark, NJ, U.S.A
| | - F H Samie
- Department of Dermatology, Columbia University Irving Medical Centre, New York, NY, U.S.A
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27
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Lehmann C, Rodriguez Ossa P, Vargas Manrique M, Acosta AE, Quintero Pérez Y. Eccrine Porocarcinoma with Zosteriform Metastasis. Cureus 2020; 12:e6873. [PMID: 32181102 PMCID: PMC7053679 DOI: 10.7759/cureus.6873] [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] [Indexed: 11/05/2022] Open
Abstract
Eccrine porocarcinoma is a rare malignant tumor that develops in the eccrine glands, appearing as a primary tumor, or by malignant transformation of an eccrine poroma. It is a carcinoma with high metastatic and recurrent potential; it has the same incidence in both sexes, and mainly affects the elderly. Its diagnosis, rather than clinical, is histological, and due to the rarity of the disease, it is a pathological challenge. There are no standardized treatment guidelines for porocarcinoma, but surgical resection with tumor-free margins is considered the basis of treatment, in addition to sentinel node biopsy under risk factors and individualization of each patient. For the metastatic form, chemotherapy and radiotherapy are the treatment of choice. Herein, we present the case of a man with eccrine porocarcinoma with extensive zosteriform skin metastasis and lymph node involvement, treated with chemotherapy and concomitant radiotherapy.
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Affiliation(s)
- Carlos Lehmann
- Breast and Soft Tissue Surgery, National Cancer Institute, Bogotá D.C., COL
| | | | | | - Alvaro E Acosta
- Dermatology, The National University of Colombia, Bogotá D.C., COL
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28
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Eccrine porocarcinoma of the scalp: diagnosis and importance of early surgical intervention. EUROPEAN JOURNAL OF PLASTIC SURGERY 2019. [DOI: 10.1007/s00238-019-01549-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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29
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Développement, mise en œuvre et objectifs de CARADERM, réseau national cancers cutanés rares – partie carcinomes annexiels. Ann Dermatol Venereol 2019; 146:704-710. [DOI: 10.1016/j.annder.2019.07.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Revised: 03/29/2019] [Accepted: 07/09/2019] [Indexed: 02/07/2023]
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30
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Lee KA, Cioni M, Robson A, Bataille V. Metastatic porocarcinoma achieving complete radiological and clinical response with pembrolizumab. BMJ Case Rep 2019; 12:12/9/e228917. [PMID: 31492726 DOI: 10.1136/bcr-2018-228917] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
A 67-year-old woman presented in 2012 with a crusty nodule on the left lower limb. Histopathological examination at this time reported a poorly differentiated squamous cell carcinoma (SCC). Two years later, she underwent lymphadenectomy and radiotherapy due to unilateral inguinal and pelvic sidewall nodal metastases. The following year she required excision of two subcutaneous lesions, reported pathologically to be SCC metastases. Further imaging following cyberknife radiotherapy to new brain metastases demonstrated widespread metastatic visceral disease. Twelve cycles of carboplatin and capecitabine failed to halt disease progression. In February 2017, she commenced pembrolizumab, achieving an excellent response and currently has no clinical or radiological evidence of disease. Given the unusual behaviour of her cancer, a histopathological review was requested. The diagnosis was revised to that of porocarcinoma (PC). This represents the first documented case of PC treated with immunotherapy. As of March 2019, the patient remains free of disease.
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Affiliation(s)
- Karla A Lee
- Department of Twin Research, King's College London, London, UK.,The Royal Marsden NHS Foundation Trust, London, UK
| | - Margherita Cioni
- Department of Dermatology, San Martino Policlinic Hospital, Genoa, Italy
| | - Alistair Robson
- LD Path Group, London, UK.,Department of Pathology, Instituto Portugues de Oncologia de Lisboa Francisco Gentil EPE, Lisboa, Portugal
| | - Veronique Bataille
- Kings College, London, UK.,Dermatology, West Herts NHS Trust, Hemel Hempstead, UK
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31
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Fukui K, Fujioka M, Matsuo H, Noguchi M. Eccrine Porocarcinoma on the Lateral Nose Wall: A Rare Case Report. Case Rep Dermatol 2019; 11:215-219. [PMID: 31427944 PMCID: PMC6696782 DOI: 10.1159/000501444] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Accepted: 06/07/2019] [Indexed: 11/24/2022] Open
Abstract
Eccrine porocarcinoma (EPC) is an uncommon malignant tumor derived from the eccrine sweat glands. We present a case of EPC on the lateral nose wall, in which the tumor was excised, and the resultant defect was reconstructed using a nasolabial flap. A 66-year-old female was referred to the Department of Plastic and Reconstructive Surgery to receive treatment for a cutaneous tumor on her right lateral nose wall, which had been growing rapidly for 3 months. Histological analysis of a biopsy specimen of the tumor suggested that it was a squamous cell carcinoma. Surgical excision was performed with a 3-mm margin. The tumor was histologically diagnosed as an EPC. EPC exhibits various pathological features; therefore, it is often confused with other malignant cutaneous tumors. We consider that histologically examining surgical specimens obtained via total resection, rather than incisional biopsy specimens, is important for correctly diagnosing EPC.
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Affiliation(s)
- Kiyoko Fukui
- Plastic and Reconstructive Surgery, National Hospital Organization Nagasaki Medical Center, Nagasaki, Japan
| | - Masaki Fujioka
- Plastic and Reconstructive Surgery, National Hospital Organization Nagasaki Medical Center, Nagasaki, Japan
| | - Haruka Matsuo
- Plastic and Reconstructive Surgery, National Hospital Organization Nagasaki Medical Center, Nagasaki, Japan
| | - Miho Noguchi
- Plastic and Reconstructive Surgery, National Hospital Organization Nagasaki Medical Center, Nagasaki, Japan
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32
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Nazemi A, Higgins S, Swift R, In G, Miller K, Wysong A. Eccrine Porocarcinoma: New Insights and a Systematic Review of the Literature. Dermatol Surg 2018; 44:1247-1261. [PMID: 29894433 DOI: 10.1097/dss.0000000000001566] [Citation(s) in RCA: 58] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND Eccrine porocarcinoma (EPC) is a rare cutaneous neoplasm with high potential for morbidity and mortality. Due to its rarity, there is a paucity of data profiling diagnosis, work-up, and management. OBJECTIVE To consolidate reported information on demographics, diagnostics, clinical behavior, treatment modalities, and patient outcomes in EPC to provide a reference tool to optimize diagnosis and management. METHODS A comprehensive PubMed search was performed from 1963 to November 2017 using PRISMA guidelines. This yielded 155 articles detailing 206 cases of porocarcinoma. RESULTS Eccrine porocarcinoma most often presents in elderly patients on the head and neck or lower limbs. Metastatic disease at presentation is not uncommon (22%). Primary tumor location is significantly correlated with presence of metastasis (p = .038). The most common treatment is excision followed by Mohs micrographic surgery (MMS), although the outcomes after MMS were superior to those after surgical excision. CONCLUSION This systematic review of individual patient data reveals that all patients should have a histological diagnosis with imaging considered for high-risk cases. Primary tumor location should also be considered in diagnostic and therapeutic decision-making. Although wide local excision (WLE) is currently the first-line treatment, MMS is becoming increasingly used, with evidence indicating improved outcomes as compared to those seen with WLE.
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Affiliation(s)
| | | | | | | | | | - Ashley Wysong
- Otolaryngology-Head and Neck Surgery, Keck Medicine of USC, Los Angeles, California
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33
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Ramasenderan N, Shahir H, Omar SZ. A synchronous incidence of eccrine porocarcinoma of the forearm and facial squamous cell carcinoma: A case report. Int J Surg Case Rep 2017; 42:116-120. [PMID: 29245095 PMCID: PMC5730414 DOI: 10.1016/j.ijscr.2017.11.066] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2017] [Revised: 11/27/2017] [Accepted: 11/28/2017] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Cutaneous appendageal tumor can differentiate towards or arise from either pilosebaceous apparatus or the eccrine sweat glands. Appendageal tumors are relatively rare, their clinical appearance is non-specific, and the vast majority are not diagnosed until after excision. Eccrine porocarcinoma (EP), also known as malignant eccrine poroma is a rare adnexal tumor arising from the intraepithelial ductal parts of the sweat gland. CASE PRESENTATION We presented a 65-year-old, Asian, female with medical co-morbids, who came with both a facial squamous cell carcinoma and a long-standing lesion over her left forearm. Histopathological finding of the left forearm demonstrated eccrine porocarcinoma. CONCLUSION Mohs micrographic surgery is the mainstay treatment of cutaneous carcinoma. It is important to rule out associated syndromes in patient who present with multiple cutaneous appendageal tumors.
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Affiliation(s)
- Nandinii Ramasenderan
- Department of Plastic and Reconstructive Surgery, Sultanah Nur Zahirah Hospital, Jalan Sultan Mahmud, 20400, Kuala Terengganu, Terengganu, Malaysia.
| | - Hasliza Shahir
- Department of Plastic and Reconstructive Surgery, Sultanah Nur Zahirah Hospital, Jalan Sultan Mahmud, 20400, Kuala Terengganu, Terengganu, Malaysia
| | - Siti Zarqah Omar
- Department of Pathology, Sultanah Nur Zahirah Hospital, Jalan Sultan Mahmud, 20400, Kuala Terengganu, Terengganu, Malaysia
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Abstract
BACKGROUND Adnexal carcinomas (ACs) are rare cutaneous malignancies of sweat gland or pilosebaceous origin. Optimal treatment and metastatic potential of AC are poorly defined. Mohs micrographic surgery (MMS) has been increasingly used to treat AC. OBJECTIVE To review selected primary cutaneous AC and their treatment outcomes with MMS. MATERIALS AND METHODS Literature review using PubMed search for articles related to primary cutaneous ACs. RESULTS Sebaceous carcinoma treated with MMS recurred and metastasized in 6.4% and 3.7%, respectively. Primary cutaneous mucinous carcinoma treated with MMS recurred and metastasized in 9.6% and 6.4%, respectively. After MMS, 4.7% of microcystic AC recurred with no reported metastases. After MMS, recurrences and metastases of trichilemmal carcinoma or hidradenocarcinoma have not been reported. Two (4.2%) regional lymph node metastases but no distant metastases or local recurrences have been reported in eccrine porocarcinoma. Squamoid eccrine duct tumor, pilomatrix carcinoma, and spiradenocarcinoma treated with MMS are also reviewed. CONCLUSION The rarity of ACs and the lack of comparative data on treatment makes conclusive recommendations on treatment difficult. Recent large case series and reviews suggest MMS is a useful and possibly superior treatment for AC and should be considered if primary cutaneous disease is suspected.
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35
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Horwich MD, Finch J, Ibrahimi O, Dadras SS. Eosinophilic variant of eccrine porocarcinoma of the scalp: Case report and review of the literature. Int J Womens Dermatol 2017; 3:157-160. [PMID: 28831427 PMCID: PMC5555270 DOI: 10.1016/j.ijwd.2017.06.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Revised: 06/13/2017] [Accepted: 06/13/2017] [Indexed: 11/25/2022] Open
Abstract
Porocarcinoma is a rare malignant neoplasm of the acrosyringium with metastatic potential that most commonly presents on the acral skin in older adults (mean age = 72 years). We present the case of a 43-year-old woman who developed a rapidly growing de novo porocarcinoma on the scalp with an unusual oncocytic appearance. The tumor consisted of benign eccrine poroma that arose from the epidermis and broad pushing borders with minimal cytological atypia but ample eosinophilic cytoplasm with numerous mitotic figures. Although some tumors may appear deceptively bland, the histologic recognition of pushing/infiltrative borders and mitotic figures are helpful to make the appropriate diagnosis of carcinoma. This lesion was treated with Mohs micrographic surgery and the patient remained free of recurrence after more than 2 years. It is important to recognize the eosinophilic variants of eccrine porocarcinoma because it can histologically mimic a squamous cell carcinoma.
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Affiliation(s)
- M D Horwich
- Department of Dermatology, University of Connecticut School of Medicine, Farmington, CT
| | - J Finch
- Department of Dermatology, University of Connecticut School of Medicine, Farmington, CT
| | - O Ibrahimi
- Department of Dermatology, University of Connecticut School of Medicine, Farmington, CT
| | - S S Dadras
- Department of Dermatology, University of Connecticut School of Medicine, Farmington, CT.,Departments of Pathology and Genetics/Genomic Sciences, Farmington, CT
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36
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Porocarcinoma; presentation and management, a meta-analysis of 453 cases. Ann Med Surg (Lond) 2017; 20:74-79. [PMID: 28721214 PMCID: PMC5499034 DOI: 10.1016/j.amsu.2017.06.027] [Citation(s) in RCA: 68] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2017] [Revised: 06/18/2017] [Accepted: 06/18/2017] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND porocarcinoma is a rare sort of skin cancer developing from sweat glands. Its clinical course and management are not well understood. OBJECTIVES the current meta-analysis is to address the presentation and management of porocarcinoma. DATA SOURCES Web of Science, PubMed, MEDLINE on OVID and Google scholar were searched for English-language studies published before December 1, 2016. RESULTS The review of literature revealed 453 cases. From which 222 (49%) cases were male and female were 231 (51%). The mean age was 67.57 years. The mean duration of presentation was 5.57 years ranging from 4 days to 60 years of age. The most common site of affection is the head and neck (39.9%) followed by lower extremity (33.9%). Mass and nodule are the most common modes of presentation. Metastasis occurred at presentation in 110 (31%) cases. The most common organ to which porocarcinoma metastizes is the nearby lymph node (57.7%). CONCLUSIONS Porocarcinoma is an aggressive skin cancer. Surgery is the main modality of treatment. SYSTEMATIC REVIEW REGISTRATION NUMBER reviewregistry233.
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Gómez-Zubiaur A, Medina-Montalvo S, Vélez-Velázquez M, Polo-Rodríguez I. Eccrine Porocarcinoma: Patient Characteristics, Clinical and Histopathologic Features, and Treatment in 7 Cases. ACTAS DERMO-SIFILIOGRAFICAS 2017. [DOI: 10.1016/j.adengl.2017.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Abstract
BACKGROUND Eccrine porocarcinoma (EPC) is a rare malignant adnexal neoplasm with reported metastatic potential and undefined optimal treatment. OBJECTIVE This study reviews the clinical characteristics and outcomes of patients with EPC treated with Mohs micrographic surgery (MMS). MATERIALS AND METHODS The authors performed a retrospective chart review of patients with EPC treated by MMS at the Mayo Clinic from 1995 to 2013, recording patient demographics, tumor characteristics, MMS stages to clearance, follow-up, recurrence, metastasis, and mortality. RESULTS A total of 9 patients underwent MMS for EPC in 19 years. The average age was 64.2 years, with 6 males and 3 females. All patients were Caucasian. The head and lower extremity were the most common locations (44% each), with 1 on the forearm. Of the 9 tumors, 8 were located on the right side of the body. The mean preoperative tumor size and postoperative defect were 2.9 and 7.8 cm, respectively, when 2 outliers were excluded. An average of 1.3 MMS stages was required for clearance. The mean postoperative follow-up was 3.3 years (range: 1-60 months). No tumors treated with MMS recurred, metastasized, or led to disease-related mortality. CONCLUSION Mohs micrographic surgery seems to be a useful treatment modality for EPC. This is one of the largest single-center series of EPC treated with MMS.
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Gómez-Zubiaur A, Medina-Montalvo S, Vélez-Velázquez MD, Polo-Rodríguez I. Eccrine Porocarcinoma: Patient Characteristics, Clinical and Histopathologic Features, and Treatment in 7 Cases. ACTAS DERMO-SIFILIOGRAFICAS 2017; 108:e27-e32. [PMID: 28110827 DOI: 10.1016/j.ad.2016.04.024] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2016] [Revised: 04/11/2016] [Accepted: 04/23/2016] [Indexed: 10/20/2022] Open
Abstract
Eccrine porocarcinoma is a rare, malignant cutaneous adnexal tumor that arises from the ducts of sweat glands. Found mainly in patients of advanced age, this tumor has diverse clinical presentations. Histology confirms the diagnosis, detects features relevant to prognosis, and guides treatment. Growth is slow, but the prognosis is poor if the tumor metastasizes to lymph nodes or visceral organs. We report 7 cases of eccrine porocarcinoma, describing patient characteristics, the clinical and histopathologic features of the tumors, and treatments used. Our observations were similar to those of other published case series. Given the lack of therapeutic algorithms or protocols for this carcinoma, we propose a decision-making schema based on our review of the literature and our experience with this case series. The algorithm centers on sentinel lymph node biopsy and histologic features.
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Affiliation(s)
- A Gómez-Zubiaur
- Servicio de Dermatología Médico-Quirúrgica y Venereología, Hospital Universitario Príncipe de Asturias, Universidad de Alcalá, Alcalá de Henares, Madrid, España.
| | - S Medina-Montalvo
- Servicio de Dermatología Médico-Quirúrgica y Venereología, Hospital Universitario Príncipe de Asturias, Universidad de Alcalá, Alcalá de Henares, Madrid, España
| | - M D Vélez-Velázquez
- Servicio de Anatomía Patológica, Hospital Universitario Príncipe de Asturias, Universidad de Alcalá, Alcalá de Henares, Madrid, España
| | - I Polo-Rodríguez
- Servicio de Dermatología Médico-Quirúrgica y Venereología, Hospital Universitario Príncipe de Asturias, Universidad de Alcalá, Alcalá de Henares, Madrid, España
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Fujimine-Sato A, Toyoshima M, Shigeta S, Toki A, Kuno T, Sato I, Watanabe M, Niikura H, Yaegashi N. Eccrine porocarcinoma of the vulva: a case report and review of the literature. J Med Case Rep 2016; 10:319. [PMID: 27832810 PMCID: PMC5105286 DOI: 10.1186/s13256-016-1106-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2016] [Accepted: 10/19/2016] [Indexed: 12/22/2022] Open
Abstract
Background Malignant tumors arising from the vulva account for only 0.6 % of all cancers in female patients. The predominant histologic type, representing about 90 % of these malignancies, is squamous cell carcinoma. Eccrine porocarcinoma is a rare malignant tumor arising from sweat glands. The incidence of eccrine porocarcinoma is estimated at 0.005–0.01 % of all cutaneous tumors. To the best of our knowledge, only seven previous cases of vulvar eccrine porocarcinoma have been reported in the English-language literature. We present the case of a patient with eccrine porocarcinoma of the vulva, and we summarize the clinical features of this disease using seven previously reported cases. Case presentation A 54-year-old Japanese woman visited a local hospital complaining of fever and left vulvar pain for 2 months. An initial examination revealed a 1 × 1 cm, firm, ulcerative mass in the inner aspect of the left labium minorum. With a preoperative diagnosis of vulvar squamous cell carcinoma, we performed a radical local excision followed by bilateral inguinal lymphadenectomy. Histological examination showed eccrine porocarcinoma, stage IB (T1bN0M0). Radiation therapy with weekly cisplatin administration was then given as adjuvant therapy. One month after treatment was completed, computed tomography revealed multiple metastases in the bilateral lungs and in the sacral bone. The patient received three courses of chemotherapy (paclitaxel and carboplatin) and underwent palliative radiation therapy to the sacrum. She died of her disease 12 months after surgery. Conclusions We report the case of a patient with eccrine porocarcinoma of the vulva and summarize the clinical features and the treatment options of eccrine porocarcinoma from a few retrospective case reports. Although eccrine porocarcinoma is a rare disease, clinicians and pathologists should be aware of its clinical and histological features and its biological behavior.
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Affiliation(s)
- Ayako Fujimine-Sato
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, 1-1, Seiryo, Aoba, Sendai, 980-8574, Japan
| | - Masafumi Toyoshima
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, 1-1, Seiryo, Aoba, Sendai, 980-8574, Japan.
| | - Shogo Shigeta
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, 1-1, Seiryo, Aoba, Sendai, 980-8574, Japan
| | - Asami Toki
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, 1-1, Seiryo, Aoba, Sendai, 980-8574, Japan
| | - Takashi Kuno
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, 1-1, Seiryo, Aoba, Sendai, 980-8574, Japan
| | - Izumi Sato
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, 1-1, Seiryo, Aoba, Sendai, 980-8574, Japan.,Present address: Department of Obstetrics and Gynecology, Sendai Red Cross Hospital, 2-43-3, Yagiyama-honcho, Taihaku, Sendai, Japan
| | - Mika Watanabe
- Department of Pathology, Tohoku University Graduate School of Medicine, 1-1, Seiryo, Aoba, Sendai, 980-8574, Japan
| | - Hitoshi Niikura
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, 1-1, Seiryo, Aoba, Sendai, 980-8574, Japan
| | - Nobuo Yaegashi
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, 1-1, Seiryo, Aoba, Sendai, 980-8574, Japan
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Montes-Torres A, Pérez-Plaza A, Llamas-Velasco M, Gordillo C, De Argila D, García-García C, Fraga J, Marín A, Ballesteros AI, Daudén E. Eccrine porocarcinoma with extensive cutaneous metastases. Int J Dermatol 2015; 55:e156-60. [PMID: 26566927 DOI: 10.1111/ijd.13121] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2014] [Revised: 10/31/2014] [Accepted: 01/02/2015] [Indexed: 11/28/2022]
Abstract
BACKGROUND Eccrine porocarcinoma (EPC) is an uncommon malignant neoplasm that originates in the intraepidermal portion of the eccrine sweat duct. Although porocarcinoma is a slow-growing tumor, up to 20% of cases can metastasize to regional lymph nodes, thus increasing mortality. METHODS We describe the clinical and histopathological features and clinical course of three cases of extensive metastatic EPC diagnosed in our department over the last 10 years. RESULTS All three patients were women aged 89-96 years. They had numerous skin tumors on the left leg that were histologically and immunohistochemically diagnosed as metastatic EPC. Only one patient had a history of primary porocarcinoma, which had been excised 6 years earlier. The remaining two patients had a previous lesion diagnosed as squamous cell carcinoma. We treated the patients with palliative radiotherapy and/or chemotherapy. Only one patient is currently alive. CONCLUSIONS The cases of cutaneous and regional metastatic EPC we present occurred in elderly women with major involvement of the left leg. The third case is noteworthy, as the patient presented a long latency period before metastases appeared. Difficulties in the clinical diagnosis--and occasionally histological diagnosis--of primary EPC could delay more aggressive treatment, although optimal treatment does not always guarantee a good prognosis.
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Affiliation(s)
| | | | - Mar Llamas-Velasco
- Department of Dermatology, Hospital Universitario de La Princesa, Madrid, Spain
| | - Carlos Gordillo
- Department of Pathology, Hospital Universitario de La Princesa, Madrid, Spain
| | - Diego De Argila
- Department of Dermatology, Hospital Universitario de La Princesa, Madrid, Spain
| | | | - Javier Fraga
- Department of Pathology, Hospital Universitario de La Princesa, Madrid, Spain
| | - Alicia Marín
- Department of Radiation Oncology, Hospital Universitario de La Princesa, Madrid, Spain
| | | | - Esteban Daudén
- Department of Dermatology, Hospital Universitario de La Princesa, Madrid, Spain
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Erfurt-Berge C, Erdmann M, Brauner K, Bauerschmitz J. Eccrine porocarcinoma mimicking a venous leg ulcer. Int Wound J 2015; 13:1063-4. [PMID: 26400442 DOI: 10.1111/iwj.12479] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2015] [Accepted: 07/13/2015] [Indexed: 11/30/2022] Open
Affiliation(s)
| | - Michael Erdmann
- Department of Dermatology, University Hospital Erlangen, Erlangen, Germany
| | - Kathrin Brauner
- Department of Dermatology, University Hospital Erlangen, Erlangen, Germany
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Abstract
Porocarcinoma is a rare malignant neoplasm that arises from the intraepidermal ductal portion of the eccrine sweat glands. This neoplasm most often presents in elderly individuals on the lower extremities. We present an unusual case of porocarcinoma arising on the scalp of a young patient. To the best of our knowledge, there have been fewer than 20 cases of porocarcinomas arising at this site reported in the literature.
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Borgognoni L, Lorenzo B, Pescitelli L, Leonardo P, Urso C, Carmelo U, Brandani P, Paola B, Sestini S, Serena S, Chiarugi C, Cristina C, Gelli R, Riccardo G, Giannotti V, Vanni G, Gerlini G, Gianni G. A rare case of anal porocarcinoma treated by electrochemotherapy. Future Oncol 2015; 10:2429-34. [PMID: 25525852 DOI: 10.2217/fon.14.141] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
We report the case of an old woman with an eccrine porocarcinoma unusually localized in the perianal area treated by electrochemotherapy, a new technique, emerging as a very effective local treatment of different skin metastases and selected primary tumors. Electrochemotherapy was performed taking into account patient wishes and refusal of demolitive surgery. The electrochemotherapy treatment was well tolerated by the patient, it gave an excellent clinical response and a complete clinical regression with no sphincter dysfunction and signs of relapse observed during follow-up. The case is of particular interest for the exceptional localization of porocarcinoma for the first time treated by electrochemotherapy in this area. Electrochemotherapy could be considered as an alternative option for selected cases of cutaneous tumors.
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Affiliation(s)
| | - Borgognoni Lorenzo
- Unit of Plastic & Reconstructive Surgery, Regional Melanoma Referral Center, SM Annunziata Hospital, Tuscan Tumour Institute, Florence, Italy
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Mohs micrographic surgery for eccrine porocarcinoma: an update and review of the literature. Dermatol Surg 2015; 41:301-6. [PMID: 25742554 DOI: 10.1097/dss.0000000000000286] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Eccrine porocarcinoma (EPC) is a rare malignancy of the eccrine sweat glands that is locally aggressive with a high propensity to metastasize. Most cases have been treated by wide local excision (WLE) with 20% local recurrence rate. There have been 20 cases of EPC treated with Mohs micrographic surgery (MMS) in the literature. OBJECTIVE To review the literature regarding the management of this aggressive tumor using MMS. METHODS A comprehensive literature review was conducted by searching the PubMed database using the keywords Mohs, porocarcinoma, malignant eccrine poroma, and eccrine neoplasms. RESULTS Most of the reported cases of EPC were treated by WLE, and only 20 cases were treated with MMS. Of the 20 EPC cases treated with MMS, there was only 1 nodal recurrence and no local recurrence. Other reported treatment modalities include radiation and excision with frozen sections. The authors report the second case of EPC on the temple, and the 21st case successfully treated with MMS. CONCLUSION Eccrine porocarcinoma is a rare neoplasm with potentially aggressive clinical behavior. In cases where tissue conservation is important, MMS should be considered.
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Thuruthil RR, Jayalakshmy PS, Sukumar V. A Case of Recurrent Eccrine Porocarcinoma with Regional Lymph Nodal Metastasis, Arising on a Bowen's Disease Patch. Indian J Surg 2015; 77:182-4. [PMID: 25972690 DOI: 10.1007/s12262-015-1255-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2014] [Accepted: 02/18/2015] [Indexed: 11/26/2022] Open
Abstract
Eccrine carcinomas are very rare, comprising only less than 0.005 % of all cutaneous carcinomas, as reported by Goellner et al. (Cancer 56:1147-1162, 1985). We are reporting a case of recurrent eccrine porocarcinoma (EPC) with regional lymph nodal metastasis, which arose on a Bowen's disease patch. Wide local excision of the lesion with lymph node dissection and excision of the Bowen's disease was done.
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Affiliation(s)
| | | | - Vivek Sukumar
- Department of Surgery, Government Medical College Thrissur, Thrissur, Kerala India
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Kottler D, Rivet J, Hickman G, Comte C, Duron JB, Basset-Seguin N, Lebbe C, Bagot M, Janin A. [Eccrine porocarcinoma with Bowenoid changes: a challenging diagnosis of adnexal neoplasm]. Ann Pathol 2014; 34:378-83. [PMID: 25439991 DOI: 10.1016/j.annpat.2014.08.003] [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: 01/27/2013] [Revised: 07/16/2014] [Accepted: 08/11/2014] [Indexed: 10/24/2022]
Abstract
Eccrine porocarcinoma is a rare malignant sweat gland tumor, representing less than 0.01% of all cutaneous neoplasms, with eccrin differentiation. Its acrosynringeal origin and physiopathology still remain discussed. The prognosis of this carcinoma is held to be poor with a significant risk of lymph node metastasis and local recurrence. Also, this not specific tumor can be a challenging histological diagnosis, in particular, in Bowenoid variant. We report a case of Bowenoid and keratinizing variant of eccrine porocarcinoma of the left ring finger with pejorative evolution and initial diagnosis of infiltrating squamous cell carcinoma arising in Bowen's disease. The knowledge of these patterns and identification of eccrine differentiation of the tumor are essential for the diagnosis and for adapted therapeutic care.
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Affiliation(s)
- Diane Kottler
- Service de pathologie, hôpital Saint-Louis, AP-HP, 1, avenue Claude-Vellefaux, 75010 Paris, France.
| | - Jacqueline Rivet
- Service de pathologie, hôpital Saint-Louis, AP-HP, 1, avenue Claude-Vellefaux, 75010 Paris, France
| | - Geoffroy Hickman
- Service de dermatologie, hôpital Saint-Louis, AP-HP, 1, avenue Claude-Vellefaux, 75010 Paris, France
| | - Christelle Comte
- Service de dermatologie, hôpital Saint-Louis, AP-HP, 1, avenue Claude-Vellefaux, 75010 Paris, France
| | - Jean-Brice Duron
- Service de chirurgie plastique, hôpital Saint-Louis, AP-HP, 1, avenue Claude-Vellefaux, 75010 Paris, France
| | - Nicole Basset-Seguin
- Service de dermatologie, hôpital Saint-Louis, AP-HP, 1, avenue Claude-Vellefaux, 75010 Paris, France
| | - Celeste Lebbe
- Service de dermatologie, hôpital Saint-Louis, AP-HP, 1, avenue Claude-Vellefaux, 75010 Paris, France
| | - Martine Bagot
- Service de dermatologie, hôpital Saint-Louis, AP-HP, 1, avenue Claude-Vellefaux, 75010 Paris, France
| | - Anne Janin
- Service de pathologie, hôpital Saint-Louis, AP-HP, 1, avenue Claude-Vellefaux, 75010 Paris, France
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Ioannidis S, Antoniou A, Patsatsi A, Kostogloudis N, Demiri E, Foroglou P. Eccrine porocarcinoma of the thumb in a patient with chronic exposure to benzene glue. J Hand Microsurg 2014; 7:157-60. [PMID: 26078532 DOI: 10.1007/s12593-014-0132-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2014] [Accepted: 04/22/2014] [Indexed: 11/30/2022] Open
Affiliation(s)
- Sotirios Ioannidis
- Department of Plastic Surgery, Medical School, Aristotle University of Thessaloniki, "Papageorgiou" General Hospital, Thessaloniki, Greece ; Department of Plastic and Reconstructive Surgery, Papageorgiou Hospital, Perifereiaki odos N. Efkarpia, 56224 Thessaloniki, Greece
| | - Antonios Antoniou
- Department of Plastic Surgery, Medical School, Aristotle University of Thessaloniki, "Papageorgiou" General Hospital, Thessaloniki, Greece
| | - Aikaterini Patsatsi
- Department of Dermatology, Medical School, Aristotle University of Thessaloniki "Papageorgiou" General Hospital, Thessaloniki, Greece
| | - Nikolaos Kostogloudis
- Department of Plastic Surgery, Medical School, Aristotle University of Thessaloniki, "Papageorgiou" General Hospital, Thessaloniki, Greece
| | - Efterpi Demiri
- Department of Plastic Surgery, Medical School, Aristotle University of Thessaloniki, "Papageorgiou" General Hospital, Thessaloniki, Greece
| | - Pericles Foroglou
- Department of Plastic Surgery, Medical School, Aristotle University of Thessaloniki, "Papageorgiou" General Hospital, Thessaloniki, Greece
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