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Li P, Busam KJ. Spindle cell porocarcinoma with a novel YAP1::MAML3 fusion. J Cutan Pathol 2024; 51:226-229. [PMID: 38088454 DOI: 10.1111/cup.14575] [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: 08/20/2023] [Revised: 11/16/2023] [Accepted: 11/29/2023] [Indexed: 02/02/2024]
Abstract
Porocarcinomas are rare sweat gland cancers representing the malignant counterpart to benign poromas. Their diagnosis can be challenging, especially in the absence of an associated poroma or when the tumor is poorly differentiated. Since recurrent YAP1::MAML2 and YAP1::NUTM1 fusions have been identified in poroid tumors, molecular studies provide an opportunity to support the diagnosis in challenging cases. We describe a case of a female patient in her early 90s, with a polypoid mass of the hip. Histopathologically, there was a poorly differentiated malignant spindle cell tumor adjacent to a poroma. Because of the close association with a poroma and immunoreactivity for p40, a diagnosis of spindle cell porocarcinoma was rendered, which was further supported by YAP1 immunohistochemical studies. Antibodies targeting both the N-terminus and C-terminus confirmed YAP1 rearrangement in both the poroma and the spindle cell neoplasm. Subsequent targeted RNA sequencing revealed a YAP1::MAML3 gene fusion. MAML3 has previously not yet been reported as a YAP1 fusion partner in porocarcinoma. With the illustration of a rare spindle cell variant of porocarcinoma and the identification of a novel gene fusion, this case report expands the spectrum of morphologic and genomic aberrations associated with porocarcinoma.
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Affiliation(s)
- Philippa Li
- Department of Dermatology, University of South Florida, Tampa, Florida, USA
| | - Klaus J Busam
- Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA
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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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Megahed H, Al‐Hammadi A, Al‐Nauaimi N, Al Hyassat S, Al‐Thalathini M. Primary groin porocarcinoma in a 43-year-old man successfully managed by local excision: A case report and literature review. Clin Case Rep 2023; 11:e7148. [PMID: 37720703 PMCID: PMC10502197 DOI: 10.1002/ccr3.7148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2022] [Revised: 02/24/2023] [Accepted: 03/14/2023] [Indexed: 09/19/2023] Open
Abstract
Porocarcinoma is a rare skin malignancy that should be suspected in patients with chronic skin lesions. Although it usually affects the elderly population in sun-exposed areas, it may be seen in younger populations and in nonexposed areas such as the groin.
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Affiliation(s)
- Heba Megahed
- Plastic and Reconstructive Surgery DepartmentHamad Medical CorporationDohaQatar
| | | | | | - Samir Al Hyassat
- Anatomical Pathology DepartmentHamad Medical CorporationDohaQatar
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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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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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Martineau J, Walz SN, Scampa M, Giordano S, Kalbermatten DF, Oranges CM. Spiradenocarcinoma: SEER Study of Epidemiology, Survival, and Treatment Options. J Clin Med 2023; 12:jcm12052045. [PMID: 36902832 PMCID: PMC10004548 DOI: 10.3390/jcm12052045] [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: 12/28/2022] [Revised: 02/09/2023] [Accepted: 03/02/2023] [Indexed: 03/08/2023] Open
Abstract
(1) Background: Spiradenocarcinoma is an extremely rare malignant adnexal tumor and there are only few studies on survival outcomes. Our aim was to perform an analysis of the demographic and pathological characteristics, treatment patterns, and survival outcomes of patients affected by spiradenocarcinoma. (2) Methods: The Surveillance, Epidemiology, and End Results program database of the National Cancer Institute was searched for all cases of spiradenocarcinoma diagnosed between 2000 and 2019. This database is considered representative of the US population. Demographic, pathological, and treatment variables were retrieved. Overall and disease-specific survival were computed according to the different variables. (3) Results: 90 cases of spiradenocarcinoma (47 females, 43 males) were identified. Mean age at diagnosis was 62.8 years. Regional and distant disease at diagnosis were rare, occurring in 2.2% and 3.3% of cases, respectively. Surgery alone was the most frequent treatment (87.8%), followed by a combination of surgery and radiotherapy (3.3%) and radiation therapy only (1.1%). Five-year overall survival was 76.2% and five-year disease-specific survival was 95.7%. (4) Conclusions: Spiradenocarcinoma equally affects males and females. Regional and distant invasion rates are low. Disease-specific mortality is low and is probably overestimated in the literature. Surgical excision remains the main form of treatment.
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Affiliation(s)
- Jérôme Martineau
- Department of Plastic, Reconstructive, and Aesthetic Surgery, Geneva University Hospitals, Geneva University, 1205 Geneva, Switzerland
| | - Solange N. Walz
- Department of Plastic, Reconstructive, and Aesthetic Surgery, Geneva University Hospitals, Geneva University, 1205 Geneva, Switzerland
| | - Matteo Scampa
- Department of Plastic, Reconstructive, and Aesthetic Surgery, Geneva University Hospitals, Geneva University, 1205 Geneva, Switzerland
| | - Salvatore Giordano
- Department of General and Plastic Surgery, Turku University Hospital, University of Turku, 20014 Turku, Finland
| | - Daniel F. Kalbermatten
- Department of Plastic, Reconstructive, and Aesthetic Surgery, Geneva University Hospitals, Geneva University, 1205 Geneva, Switzerland
| | - Carlo M. Oranges
- Department of Plastic, Reconstructive, and Aesthetic Surgery, Geneva University Hospitals, Geneva University, 1205 Geneva, Switzerland
- Correspondence: ; Tel.: +41-(0)223-727-997
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Epidemiology and Survival of Eccrine Porocarcinoma by Sex in the United States: A Surveillance, Epidemiology, and End Results Database Analysis. Dermatol Surg 2023; 49:97-99. [DOI: 10.1097/dss.0000000000003652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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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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