Eccrine porocarcinoma in the tempus of an elderly woman: A case report

BACKGROUND

Eccrine porocarcinoma (EPC) is a rare skin tumor that mainly affects the elderly population. Tumors often present with slow growth and a good prognosis. EPCs are usually distinguished from other skin tumors using histopathology and immunohistochemistry. However, surgical management alone may be inadequate if the tumor has metastasized. However, currently, surgical resection is the most commonly used treatment modality.

CASE SUMMARY

A seventy-four-year-old woman presented with a slow-growing nodule in her left temporal area, with no obvious itching or pain, for more than four months. Histopathological examination showed small columnar and short spindle-shaped cells; thus, basal cell carcinoma was suspected. However, immunohistochemical analysis revealed the expression of cytokeratin 5/6, p63 protein, p16 protein, and Ki-67 antigen (40%), and EPC was taken into consideration. The skin biopsy was repeated, and hematoxylin and eosin staining revealed ductal differentiation in some cells. Finally, the patient was diagnosed with EPC, and Mohs micrographic surgery was performed. We adapted follow-up visits in a year and not found any recurrence of nodules.

CONCLUSION

This case report emphasizes the diagnosis and differentiation of EPC.

Porocarcinoma in a palm reconstructed with a full thickness skin graft: A case report

BACKGROUND

Porocarcinoma is a rare type of skin cancer that originates from sweat gland tumors. It is an aggressive malignant skin cancer that is difficult to diagnose clinically owing to its rarity and similarity to squamous cell carcinoma (SCC).

CASE SUMMARY

This case involved a 92-year-old woman, a farmer by profession, presented with an exophytic and verrucous mass on her left palm that had formed 2 years prior and caused chronic pain and frequent bleeding. Initially, the patient was diagnosed with SCC using a punch biopsy; however, a repeat biopsy with additional immunohistochemical tests was performed for porocarcinoma. Ultimately, the patient was diagnosed with porocarcinoma and reconstruction was planned using a full-thickness skin graft. After treatment, the range of motion of the palm was preserved, and the aesthetic outcome was favorable. At 6 mo of follow-up, the patient was satisfied with the outcome.

CONCLUSION

Porocarcinoma is commonly misdiagnosed as SCC; therefore, clinicians should consider porocarcinomas when evaluating mass-like lesions on the hands.

Standardized surgical strategy for the treatment of preauricular sinus to reduce recurrence

BACKGROUND

Preauricular sinus (PAS) is a common congenital anomaly, and complete excision is recommended to prevent recurrence. However, PAS has a high recurrence rate as a result of incomplete removal due to the high variability of the sinus ramifications, making its treatment challenging. In this study, we standardized the surgical procedure to reduce the complications and recurrence rate and compared the postoperative results between the non-standardized and the standardized groups.

METHODS

This retrospective study included 97 patients (120 ears) who had undergone PAS excision by a single surgeon between October 2014 and September 2022 and underwent at least 6 months of follow-up. After October 2018, all patients were treated using the standardized method, which comprised the use of magnifying glasses, exploration with a lacrimal probe, the use of methylene blue staining, and excision of a piece of surrounding normal tissue and related cartilage in continuity with the specimen. There were 38 patients (45 ears) in the non-standardized group and 59 patients (75 ears) in the standardized group.

RESULTS

Recurrence was observed in six of 120 ears, indicating an overall recurrence rate of 5.0%. Recurrence occurred in five ears (11.1%) in the non-standardized group and one ear (1.3%) in the standardized group. The standardized group had a significantly lower recurrence rate (p= 0.027) than the non-standardized group.

CONCLUSION

We defined a standardized sinectomy protocol and used it for the surgical treatment of PAS. With this standardized method, we were able to reduce the rates of complications and recurrence without the use of a long incision.

Concurrent presentation of porocarcinoma and basal cell carcinoma arising on a capillary malformation: a case report

Porocarcinoma (PC) and basal cell carcinoma (BCC) are distinct skin cancers. Few studies have documented the occurrence of two concurrent types of skin cancers, and to the best of our knowledge, this represents the inaugural report of such a coexisting lesion arising from a capillary malformation. Herein, we report a case of concurrent PC and BCC presenting with capillary malformation. A 93-year-old woman visited our hospital with a protruding mass in her right nasal ala that appeared as a capillary malformation. A biopsy was performed on the skin lesion, and BCC was diagnosed. A wide excision was performed. Permanent biopsy revealed that the skin lesion was a PC with basal cells and squamous differentiation. The safety margin of the deep tissue margin was < 0.1 cm; however, considering the advanced age of the patient, further excision was deemed to not possess any benefits. This case illustrates the importance of recognizing the possibility of multiple skin cancers, even in patients with benign lesions such as capillary malformations. The rarity of this presentation highlights the importance of thorough investigation and histopathological examination of skin lesions in guiding appropriate surgical excision.

Eccrine Porocarcinoma of Dorsum of Nose: A Rare Case Report

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.

Rare case of large eccrine poroma of the eyelid

Eccrine poroma is a rare tumor arising from sweat glands with common location being soles and palms. We are reporting a case of 70-year male patient with large lower lid mass lesion. Owing to its location and history of growth, malignancy was suspected. Biopsy proved it to be eccrine poroma which is a benign lesion. Complete excision with lid reconstruction was done. Eccrine poroma, though rare, should be kept in the differential diagnosis of eyelid tumors. Owing to the risk of malignant transformation and difficulty in clinical differentiation between poroma and porocarcinoma, wide excision should be done.

Eccrine Porocarcinoma: A Challenging Diagnostic and Therapeutic Tumoral Entity

Eccrine porocarcinoma is a rare malignant cutaneous tumor with high rates of extracutaneous spread, and its diagnosis and management can be quite challenging. This is a case of an 82-year-old woman presenting with an asymptomatic and chronic pubic skin lesion for whom the work-up required many investigations and procedures to confirm the diagnosis of metastatic eccrine porocarcinoma. Indeed, the patient underwent a wide local excision of the skin lesion, imaging with an FDG-PET scan, a colonoscopy, and two inguinal node dissections. As illustrated in this case, surgery should always be considered to achieve disease remission. Other treatments such as chemotherapy and radiotherapy have also been reported in the literature without clear standard guidelines.

Engrailed Homeobox 1 and Cytokeratin 19 Are Independent Diagnostic Markers of Eccrine Porocarcinoma and Distinguish It From Squamous Cell Carcinoma

OBJECTIVES

The diagnostic utility of En1 in the histopathologic differentiation of eccrine porocarcinoma (EPC) from invasive squamous cell carcinoma (SCC) was investigated.

METHODS

Expression of En1 and CK19 in 16 cases of EPC was immunohistochemically examined and compared with that in 32 cases of SCC.

RESULTS

In all 16 EPCs, En1 was expressed in 3% to 100% of tumor cells. In 20 of the 32 SCCs, En1 was expressed in 3% to 90% of tumor cells. A total of 13 of the 16 EPCs and five of the 32 SCCs were judged as En1 positive, with a cutoff value of 25%. In addition, 11 of the 16 EPCs and four of the 32 SCCs were CK19 positive. The frequencies of En1- and CK19-positive cases were significantly higher in EPCs than in SCCs. In a logistic regression analysis for predicting EPC, En1 and CK19 were independent markers. When expression patterns of En1 and CK19 were combined, none of the 32 SCCs was both positive. In contrast, 15 of the 16 EPCs were positive for either En1 or CK19.

CONCLUSIONS

A combination of En1 and CK19 expression can improve the accuracy of histologic diagnosis of EPC.

Intergluteal Cleft Eccrine Porocarcinoma with Metastasis to Inguinal Region and Lung: Case Report and Review of the Literature

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.

Eccrine Porocarcinoma: A Multicenter Retrospective Study with Review of the Literatures Reported in Korea

BACKGROUND

Eccrine porocarcinoma (EPC) is a rare malignant cutaneous adnexal tumor. Other than several scattered case reports, no comprehensive review on EPC has been conducted in Korea.

OBJECTIVE

To clinicopathologically review all EPC cases from our institutions as well as those reported in Korea.

METHODS

Medical records and histopathological slides of EPC cases in the skin biopsy registries of our institutions were retrospectively reviewed. Additionally, EPC cases reported in Korea before June 2019 were retrieved by searching the PubMed, KoMCI, KoreaMed, and KMbase databases.

RESULTS

Nine EPC cases from our institutions were included in the study. In addition, 27 reports of 28 patients with EPC were reported in Korea. A total of 37 patients with EPC were identified, consisting of 19 males (male:female ratio, 1.06:1; mean age at diagnosis, 65.6 years). The most common site of primary tumor was the head and neck (29.7%). Wide excision was the most common (78.4%) treatment method. Initial metastasis work-up imaging studies were performed in 18 patients (48.6%), and metastasis was confirmed in eight patients (21.6%).

CONCLUSION

EPC is a rare cutaneous carcinoma in Korea. EPC usually affects elderly patients, with no sexual predilection. Due to possible metastasis, careful diagnosis and appropriate metastasis work-ups are warranted in EPC.

A case of eccrine porocarcinoma characterized by a progressive increase in the level of Ki-67 index: case report and review of literature

Background

Eccrine porocarcinoma is an extremely rare skin adnexal malignant neoplasia with highly invasive and metastatic potential. We report an additional case of eccrine porocarcinoma with intracranial metastases. This case is characterized by a complete record of the progress of eccrine porocarcinoma, its immunohistochemistry after three operations showed a progressive increase in the level of Ki-67 index.

Case presentation

We herein report a case of a 37-year-old-male with eccrine carcinoma occurring on the left posterior occipital scalp which invaded the skull and dura, presenting with progressive headache. This patient has performed three surgeries in total. During the last hospitalization, he underwent an extended surgical resection, lymphadenectomy, myocutaneous flap transplantation and vascular anastomosis in our institution. After surgery, he was treating with radiotherapy at 200 Gray in 12 fractions. But one year after the operation, he developed chest tightness, imaging examination and biopsy puncture revealed pulmonary metastasis.

Conclusion

Intracranial metastasis of eccrine porocarcinoma is a late event with poor prognosis. This case emphases on that progressively increased level of Ki-67 index may predict more chance to occur the intracranial metastasis of scalp eccrine porocarcinoma, long-term follow-up and appropriately dense follow-up interval is necessary.

Zosteriform Lymphangitic Metastases of Eccrine Porocarcinoma

Eccrine porocarcinoma (EPC) is a rare malignant neoplasm which originates from the intraepidermal portion of eccrine sweat glands or acrosyringium. Here, we report a unique case of cutaneous metastases of EPC presenting with an erosive plaque on the left thumb and multiple nodules on left forearm. The histopathological examination of the wrist lesion revealed islands of basaloid tumor cells with eosinophilic cytoplasm, downward infiltrating growths, ductal differentiation, and intracytoplasmic lumen formations and focally connected to the epidermis. Acrosyringeal differentiation was confirmed by positive immunohistochemical staining using antibodies to carcinoembryonic antigen (CEA) and epithelial membrane antigen (EMA) in some of porocarcinoma cells. Lymphatic embolization was shown by immunostaining of podoplanin. To the best of our knowledge, this is the first reported EPC case with a primary lesion on the left thumb and zosteriform growth pattern of lymphangitic metastases on left forearm. Our case highlights the diagnostic challenges and reveals lymphangitic metastasis mode of EPC.

Results of Surgical Treatment of Patients with Malignant Eccrine Poroma

Objectives:

Malignant eccrine poroma is a rare cutaneous malignancy. This study was a review of a series of patients with malignant eccrine poroma who underwent surgical treatment conducted in order to evaluate the management techniques and outcomes of treatment modalities.

Methods:

All cases of surgically excised malignant eccrine poroma performed in a single clinic between 2012 and 2018 were included in the study. The details of patient age, gender, anatomical location of the tumor, histopathological features, and treatment modalities were analyzed.

Results:

The average tumor size was 2.53 cm (range: 0.3-7 cm). The average tumor thickness was 3.06 mm (range: 2.5-4 mm). The mean clean tumor margin after the first excision was 1.28 mm and the mean tumor margin after the second excision was 8.83 mm. No recurrence or distant metastasis was detected in any of the patients during the follow-up period.

Conclusion:

Unlike frequent skin cancers, rare skin cancers, like malignant eccrine poroma, don’t have definite treatment algorithms constituted from randomized trials. The findings of patient series are very useful to guide physicians in these cases.

Eccrine porocarcinoma on the cheek

Eccrine porocarcinoma is a rare malignant tumor arising from the intraepidermal ductal portion of the eccrine sweat gland. It develops either spontaneously or from a long standing benign eccrine poroma. This entity usually affects older people and is commonly located on the lower extremities, the trunk, and the head. We report a case of eccrine porocarcinoma on the left cheek in an 85-year-old male. In our case, the tumor was treated with wide excision and postoperative adjuvant radiation therapy. The patient recovered well without local recurrence and distant metastasis during the 14-month follow-up period. Wide excision and postoperative adjuvant radiation therapy can be considered as a safe and effective treatment option in treating patients with eccrine porocarcinoma.

Collision Tumor Associated with Sarcomatoid Eccrine Porocarcinoma and Basal Cell Carcinoma

A ‘collision’ tumor refers to the existence of two different neoplasms within the same tumor. Sometimes, the term ‘biphasic tumor’ is also used. However, a ‘collision’ tumor is defined as the occurrence of two neoplasms within proximity of each other yet maintaining distinctly defined, separate boundaries. In contrast, a ‘biphasic’ tumor demonstrates two or more phenotypically distinct neoplastic cell populations merging within the same space. Here, we report a case of collision tumor associated with sarcomatoid eccrine porocarcinoma and basal cell carcinoma arising in a 57-year-old male patient.

[Clinicopathologic characterization of malignant mixed tumor of the skin accompanied by eccrine porocarcinoma]

Objective: To investigate the clinicopathologic features, immunophenotype, pathological diagnosis and treatment of malignant mixed tumor (MMT). Methods: Clinical and pathological features including immunohistochemical phenotypes were analyzed in a case of MMT accompanied with eccrine porocarcinoma (EP) involving both hands, diagnosed definitely in January 2018 along with review of relevant literature. Results: A 64-year-old man presented with multiple rash on both hands for 4 years. Three lesions of 0.5 to 2.2 cm were removed for pathological evaluation. The pathological changes on little finger of left and right hands were MMT with EP, whereas that removed from the right ring finger was EP. MMT showed infiltrative growth with vascular wall invasion and consisted of epithelial (glandular or tube differentiation) and mesenchymal components (mucinous and/or cartilage stroma). The endothelial cells showed moderate to severe cytological atypia, nuclear pleomorphism and increased mitotic activity. The glandular component had histological characteristics of syringocarcinoma with moderately atypical chondrocytes but without myoepithelium. EP was composed of basal cells with visible vacuoles in cytoplasm and the presence of tubular and squamous differentiation, along with obvious atypia. Immunohistochemically cavosurface epithelium of glandular differentiation of MMT showed positivity for CK7, EMA and CD117. Myoepithelium showed S-100, CK5/6 and p63 positivity and stromal cells were positive for S-100. Differential diagnoses included metaplastic carcinoma, malignant myoepithelioma and atypical mixed tumor of skin. Conclusions: MMT with EP is extremely rare.The diagnosis of MMT depends on the morphologic features. Immunohistochemical staining is helpful for differential diagnosis. Surgical excision with safety margins is the treatment of choice. Complementary radiotherapy and/or chemotherapy is still controversial. The clinical course of MMT is deemed unpredictable and long-term follow-up is necessary.

Eccrine porocarcinoma arising from the knee

Enlarged eccrine porocarcinoma of the knee was encountered as a hemorrhagic bulky tumor. After controlling bleeding with Mohs’ paste, local excision of the lesion was the mainstay of treatment. Pathological examination revealed poroid cells, cuticle cells, and prickle cells cancer components, suggesting that malignancy must be excluded by resection.

Eccrine Porocarcinoma: Patient Characteristics, Clinical and Histopathologic Features, and Treatment in 7 Cases

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.

Cytodiagnosis of Eccrine Porocarcinoma of the Scalp

Eccrine porocarcinoma is a rare, malignant adnexal tumor of the duct of eccrine sweat gland. Cytology of eccrine porocarcinoma has been described in very few previous literature. Here, we present a case of fine needle aspiration cytology (FNAC) of eccrine porocarcinoma of the scalp, which is subsequently confirmed by histology. Accurate diagnosis of eccrine porocarcinoma by FNAC is very difficult, but determining the malignant nature of the lesion is crucial for curative surgery. FNAC can be a convenient, safe, and effective approach to solve difficult diagnostic dilemma.

Metastatic Eccrine Porocarcinoma: A Rare Case of Successful Treatment

The successful treatment of the rare malignancy eccrine porocarcinoma (EP) is extremely challenging, often not rewarding and when associated with metastatic disease, therapy results are disappointing. We present a unique case of treatment response of metastatic EP, with a significant disease-free interval. The patient has remained in clinical and radiological remission for 36 months since diagnosis of metastatic disease.

Malignant Eccrine Poroma of the Vulva: An Intriguing Case of a Rare Tumor at an Unusual Site

Malignant eccrine poroma is a rare malignancy of the eccrine sweat glands, occurring most frequently on the lower extremities. It affects both sexes equally usually in the 6(th) to 7(th) decade of life. Metastasis to regional lymph nodes may occur in 20% that may be fatal in 60% cases. Its aggressive nature, rarity of occurrence, and unusual presentations make it very important to be evaluated properly by the clinician. We hereby report a case of a 75-year-old female presenting with two exophytic tumors over her vulva with local extension. On histopathological examination, it was diagnosed as malignant eccrine poroma. On magnetic resonance imaging of the pelvic region, metastatic extension in regional lymph nodes was found. She was treated by radical vulvectomy with bilateral inguinal and femoral lymph node dissection followed by radiotherapy.

Eccrine Porocarcinoma presenting as an abdominal wall mass in a patient with ulcerative colitis-A rare case report

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Eccrine Porocarcinoma (EPC) is rare. It seldom occurs in the early 20s, or arises in the abdominal wall

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EPC is easily misdiagnosed due to lack of specific morphological features. Clinical picture usually consists of a painless nodule or papule

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Definitive diagnosis is achieved by histopathological examination

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Early definitive surgical excision with wide tumor free margins leads excellent results. Risk of local recurrence is about 20%

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High index of suspicion for EPC should be maintained in patients with cystic abdominal wall masses, especially in case of ulceration or discharge

Introduction

Eccrine porocarcinoma (EPC) is a rare malignancy of eccrine sweat glands. It is often seen during the sixth to eighth decades of life. We report the first case of eccrine porocarcinoma arising on the abdomen of a 21-year-old patient with ulcerative colitis.

Case presentation

A 21-Year-old female presented to emergency department with a one month history of an enlarging mass over left lower abdomen. Abdominal examination revealed a slightly erythematous, nodular and non-mobile firm mass in left lower quadrant. There was superficial ulceration with slight serous discharge. CT scan of the abdomen and pelvis with contrast revealed a superficial cystic lesion over the anterior abdominal wall, provisionally diagnosed as sebaceous cyst. Incision and drainage were performed and on follow-up, no signs of healing were observed and the patient subsequently underwent surgical excision. Histopathological examination revealed an eccrine porocarcinoma.

Discussion

EPC is a rare and aggressive tumor. It may occur de novo or as a result of malignant transformation of an eccrine poroma. A long period of clinical history is often encountered. It usually occurs on the lower extremities followed by the, trunk, head and neck, and upper extremities. The clinical picture usually consists of a painless nodule or papule. Treatment is wide local excision. No strong evidence exists for adjuvant therapy. The risk of local recurrence is about 20%.

Conclusion

High index of suspicion is required for diagnosis of EPC. Early diagnosis is achieved by histopathological examination and early definitive surgical excision leads to excellent results.

Eccrine Porocarcinoma of the Scalp: A Rare Case Report with Review of Literature

Eccrine porocarcinoma (EPC) is a potentially lethal neoplasm of the skin that arises from the intraepidermal portion of the eccrine sweat glands. It was previously known as eccrine adenocarcinoma or malignant eccrine poroma. It commonly occurs between 60 to 80 years of age, usually arising from hands and feet. However, few case reports on involvement of rare sites such as scalp, face and eyelids are present in literature. We herein report an unusual case of porocarcinoma arising on the right parieto occipital region of scalp in a 29-year-old young female patient. To the best of our knowledge, there have been fewer than 20 cases of porocarcinoma arising on scalp with fewer than 10 cases seen in younger age group reported previously in the literature.

[A case report of eccrine porocarcinoma]

Eccrine porocarcinoma (EPC) is a rare malignant skin appendage tumour deriving from the intraepithelial ductal parts of the sweat glands. First described by Pinkus e Mehregan nel 1963 as an epidermotropic eccrine carcinoma, it is rarely reported in medical literature and represents 0.005-0.01% of all skin tumors. We report a case of a 88-year-old Caucasian female presented to our Clinic with an asymptomatic, red-brown , irregularly shaped firm nodule on the left thigh aroused 15 years earlier. The lesion has been excised and histopathological examination showed an "eccrine porocarcinoma aroused on eccrine poroma". Review of the literature on this rare condition and possible therapeutic strategies are also discussed.

[Eccrine porocarcinoma with Bowenoid changes: a challenging diagnosis of adnexal neoplasm]

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.

Successful Treatment of Eccrine Porocarcinoma Metastasized to a Cervical Lymph Node with CyberKnife Radiosurgery

Eccrine porocarcinoma is a rare type of skin cancer that originates from eccrine sweat glands or acrosyringium and mainly occurs in the elderly. In this report, we describe an 85-year-old Japanese woman with eccrine porocarcinoma that metastasized to a cervical lymph node who was cured with CyberKnife radiosurgery. Because our patient had a high risk of perioperative complication, standard surgical therapy with a wide margin was impractical. Our present study suggests the novel possibility of using CyberKnife for the treatment of inoperable metastatic porocarcinoma.

[Primary eccrine porocarcinoma: a clinicopathological study of 50 cases]

BACKGROUND

Eccrine porocarcinoma is a rare cutaneous tumor arising from the intra-epidermal portion of eccrine sweat glands, the acrosyringium. Histoprognostic studies in large series are rare. Herein, we report a retrospective study of 50 cases.

PATIENTS AND METHODS

Fifty cases of porocarcinoma were retrieved from a histopathological register. Each histopathological sample was evaluated for the following criteria: presence or absence of dermal invasion, pattern of the infiltrative component (pushing or infiltrative), tumor thickness, lymphovascular emboli, perineural invasion and mitotic index. Clinical data and outcome were also retrieved for each patient.

RESULTS

Mean patient age was 77 years (range: 43-99 years). The mean duration of progression prior to diagnosis was 4 years and 5 months. The 2 most common skin locations were the head (38%) and lower limbs (20%). The lesions showed no specific distinctive clinical features. Six cases were in situ, and 44 were invasive (23 with limited infiltration and 20 with scattered infiltration). Mean tumor thickness was 4.37 mm (range: 0.5 to 20 mm). Neighboring or remote epidermal involvement was noted in 7 cases. Lymphovascular emboli were observed in 3 cases. No cases of neurotropism were observed. The average mitotic index was 6.5 mitoses/high power (×400) field. A mean follow-up of 24.3 months was available for 48 patients. Local recurrence was noted in 5 patients, 4 of whom died from visceral metastases. These 5 cases showed no distinctive clinical features, a scattered pattern of the invasive component, cuticular cells, significant tumor thickness (mean 12.8 mm, range 9-20 mm), and an elevated mitotic index. Two histopathological criteria were significantly associated with a metastatic outcome: scattered pattern of the dermal invasive component (P=0.04) and significant tumor thickness, above 10mm (P<0.01).

CONCLUSION

Porocarcinoma is a tumor without any particular clinical criteria to distinguish it from squamous cell carcinoma. The architecture of the invasive component and tumor thickness constitute 2 important histoprognostic criteria.

Eccrine porocarcinoma: a case report

Eccrine porocarcinoma is an extremely rare malignancy of the eccrine sweat gland. It is believed to arise from the intra-epithelial portion of eccrine sweat glands. It can either arise de novo or it can develop in a long standing eccrine poroma. It often occurs in the elderly, with the mean age of occurrence being 67 years. The tumour favours extremities, particularly the legs and feet. The propensity to form multiple cutaneous metastases is an unusual feature of eccrine porocarcinoma. It is also associated with visceral metastasis, resulting in death. An early diagnosis and prompt treatment are thus essential, owing to the aggressive behaviour of the tumour. Keeping in view its rarity of occurrence, we are hereby presenting a case of eccrine porocarcinoma which occurred in a 55-year-old female.

Eccrine porocarcinoma: A case report and review of the literature

Eccrine porocarcinoma is a rare form of skin cancer that is often confused with other types of skin malignancy. The present paper highlights a typical case to remind plastic surgeons of the natural history, pathological findings and current literature on the management of this cancer.

Eccrine porocarcinoma: clinical and pathological report of eight cases

Background

Eccrine porocarcinoma (EPC), a slow-growing carcinoma of the sweat gland, is a rare condition documented only in a small number of case series. Due to its rarity, guidelines and specific recommendations are not widely available. Accordingly, many dermatologists encounter difficulty in diagnosing and treating EPC. The aim of this study is to report the clinical and pathological features of EPC in order to contribute to the body of information currently available on the subject.

Patients and Methods

From 2003 to 2013, 8 Japanese patients were diagnosed with EPC at the Department of Dermatology in the Hachioji Medical Center of Tokyo Medical University. Patient data, including clinical manifestations, histopathological findings, immunohistochemical results, treatment method, and clinical course were collected and documented.

Results

The mean age of the patients (6 males and 2 females) was 72.6 years. The duration of the lesions ranged from 4 months to 5 years (mean: 3.5 years). All of the lesions clinically presented with erosive reddish nodules (mean size: 39.0 mm). Initial CT imaging revealed that 1 case had multiple distant metastases. Surgical resection was performed for all primary lesions and follow-up observations were available in all cases (mean: 10.9 months). One case with distal metastases underwent both radiation therapy and chemotherapy, but nevertheless succumbed to the disease.

Conclusion

The EPC cases in our department presented a versatile clinical appearance and characteristic histopathological features.

A case of eccrine porocarcinoma: usefulness of immunostain for s-100 protein in the diagnoses of recurrent and metastatic dedifferentiated lesions

Eccrine porocarcinoma is a rare malignant tumor. Immunostain for S-100 protein, in addition to epithelial membrane antigen (EMA) and carcinoembryonic antigen (CEA), is described to be useful in the diagnosis. Herein, we report a case of eccrine porocarcinoma with immunostain for S-100 protein which was useful in diagnoses of recurrent and metastatic lesions. The primary lesion in the left inguinal region was excised, but it recurred on the same site 14 months after the resection. The recurrent lesion showed epithelioid melanocytic findings. Three months later, metastasis to the lungs was found. Since these recurrent and metastatic lesions were dedifferentiated, typical histologic findings of eccrine porocarcinoma disappeared in biopsied specimens. Nevertheless, scattered immunoreactive cells for S-100 protein were maintained in these dedifferentiated lesions. S-100 protein positive cells could be an aid to diagnose, even if histologic findings of recurrent and metastatic lesions have changed by dedifferentiation.

Eccrine porocarcinoma presenting with unusual clinical manifestations: a case report and review of the literature

Eccrine porocarcinoma is a rare neoplasm that originates from the intraepidermal ductal portion of the eccrine sweat gland, and it usually occurs on the pre-existing lesion of benign eccine poroma. Its occurrence is more common in females and elderly persons. We present a case of a 44-year-old man who suffered from eccrine porocarcinoma, which developed on the right scrotum and pelvic area with metastases to the lung, adrenal gland, esophagus, ureter, and distant lymph nodes. Here we report on a unique case of eccrine porocarcinoma that developed primarily on the scrotum, which is an uncommon site, and showed rapid metastasis to the internal organs.

A case of clear cell eccrine porocarcinoma

Eccrine porocarcinoma (EP) is a rare malignant tumor arising from the intraepidermal eccrine duct. The tumor cells frequently contain glycogen, but prominent clear cell changes in EP are rarely reported. A 78-year-old woman presented with a slightly pruritic, erythematous, verrucous plaque on her left thigh. Histopathological examination revealed intraepidermal tumor cell nests composed of small basaloid cells and duct-like structures lined by periodic acid-Schiff (PAS)-positive cuticles. Besides the typical findings of EP, clear cell changes were predominantly observed in the tumor cell aggregations. Herein we report a case of the clear cell variant of EP rarely reported in previous literature.