A case of recurrent eccrine porocarcinoma
DOI:
https://doi.org/10.22122/cdj.v4i2.224Keywords:
Eccrine Porocarcinoma, Recurrence, Sweat GlandsAbstract
BACKGROUND: Eccrine porocarcinoma, first described in 1963, is a rare malignant lesion arising from the eccrine sweat glands. It is usually a primary tumor, even more commonly, a malignant degeneration of an eccrine poroma. It usually affects elderly, and is located commonly in the lower extremities. About 20% of the cases will reappear after treatment. The treatment consists of wide local excision of the primary lesion. This uncommon skin tumor is locally aggressive and has a high recurrence rate.
CASE REPORT: We report a 95-year-old woman with a large tumor on the left knee. A large number of tumoral cells showed immunolabeling of p63 supporting squamous or myoepithelial differentiation. They were also positive for cytokeratin-7 (CK7), epithelial membrane antigen (EMA), and carcinoembryonic antigen (CEA) highlight luminal differentiation in some of the vacuolated cells and this was also seen with periodic acid-Schiff-diastase (PAS-diastase) staining.
CONCLUSION: Eccrine porocarcinoma is a rare aggressive form of skin cancer with unknown etiology, and little guidance is available in the literature on exact protocols for treatment and follow up. It should be on the differential diagnosis of any suspicious skin lesion seen by the plastic surgeon. Histologic assessment is indicated in suspicious lesions.
References
Rutten A, Requena L, Requena C. Clear-cell porocarcinoma in situ: A cytologic variant of porocarcinoma in situ. Am J Dermatopathol 2002; 24(1): 67-71.
Pinkus H, Mehregan AH. Epidermotropic eccrine carcinoma. A case combining features of eccrine poroma and paget's dermatosis. Arch Dermatol 1963; 88: 597-606.
Brown CW Jr, Dy LC. Eccrine porocarcinoma. Dermatol Ther 2008; 21(6): 433-8.
Bonadio J, Armstrong W, Gu M. Eccrine porocarcinoma: Report of a case with fine needle aspiration cytology, histopathology and immunohistochemistry. Acta Cytol 2006; 50(4): 476-80.
Marone U, Caraco C, Anniciello AM, Di Monta G, Chiofalo MG, Di Cecilia ML, et al. Metastatic eccrine porocarcinoma: Report of a case and review of the literature. World J Surg Oncol 2011; 9: 32.
Aviles-Izquierdo JA, Velazquez-Tarjuelo D, Lecona-Echevarria M, Lazaro-Ochaita P. Dermoscopic features of eccrine poroma. Actas Dermosifiliogr 2009; 100(2): 133-6.
Shiohara J, Koga H, Uhara H, Takata M, Saida T. Eccrine porocarcinoma: Clinical and pathological studies of 12 cases. J Dermatol 2007; 34(8): 516-22.
Shaw M, McKee PH, Lowe D, Black MM. Malignant eccrine poroma: A study of twenty-seven cases. Br J Dermatol 1982; 107(6): 675-80.
Kurokawa I, Urakawa Y, Senba Y, Kawabata E, Nishimura K, Omoto Y, et al. Keratin profiles may differ between intraepidermal and intradermal invasive eccrine porocarcinoma. Oncol Rep 2006; 16(3): 473-7.
Mehregan AH, Hashimoto K, Rahbari H. Eccrine adenocarcinoma. A clinicopathologic study of 35 cases. Arch Dermatol 1983; 119(2): 104-14.
Grin A, Colgan T, Laframboise S, Shaw P, Ghazarian D. "Pagetoid" eccrine carcinoma of the vulva: Report of an unusual case with review of the literature. J Low Genit Tract Dis 2008; 12(2): 134-9.
Cabrera AL, Dermatológico C, de la Pascua L, Federal D, Cardona MA, Dermatológico C, et al. Eccrine porocarcinoma of scalp: Case report and literature review. J Am Acad Dermatol 2015; 72(5): AB260.
Riera-Leal L, Guevara-Gutierrez E, Barrientos- Garcia JG, Madrigal-Kasem R, Briseno-Rodriguez G, Tlacuilo-Parra A. Eccrine porocarcinoma: Epidemiologic and histopathologic characteristics. Int J Dermatol 2015; 54(5): 580-6.
Salih AM, Kakamad FH, Baba HO, Salih RQ, Hawbash MR, Mohammed SH, et al. Porocarcinoma; presentation and management, a meta-analysis of 453 cases. Ann Med Surg (Lond) 2017; 20: 74-9.
Mulinari-Brenner FA, Mukai MM, Bastos CA, Filho EA, Santamaria JR, Neto JF. Eccrine porocarcinoma: Report of four cases and literature review. An Bras Dermatol 2009; 84(5): 519-23.
Chang O, Elnawawi A, Rimpel B, Asarian A, Chaudhry N. Eccrine porocarcinoma of the lower extremity: A case report and review of literature. World J Surg Oncol 2011; 9: 94.
Robson A, Greene J, Ansari N, Kim B, Seed PT, McKee PH, et al. Eccrine porocarcinoma (malignant eccrine poroma): A clinicopathologic study of 69 cases. Am J Surg Pathol 2001; 25(6): 710-20.
Perna C, Cuevas J, Jiménez-Heffernan J, Hardisson D, Contreras F. Eccrine Porocarcinoma (Malignant Eccrine Poroma). Am J Surg Pathol 2002; 26(2): 272-3.
Gunhan O, Karslioglu Y, Alomeroglu M, Berberoglu U. Eccrine porocarcinoma: A case with an obscure primary tumor diagnosed from lymph node metastasis. Am J Dermatopathol 2007; 29(2): 176-9.
