ABSTRACT
INTRODUCTION: Eccrine carcinoma is an extremely rare skin tumor where only 1/13000 specimens have been submitted to dermatopathological laboratories in the United States.There is no data yet to compare the Philippines with the international incidence of eccrine carcinoma. This is a case of a 69-year-old Filipino female who presented with a recurring invasive indolent tumor at the right fronto-parietal area who presented with left sided hemiparesis and seizure.CASE: The patient was presented with a recurrent invasive indolent mass on her right front-parietal area, grossly measuring five by four centimeters, nodular flesh colored,which extended intracranially.This was associated with left sided hemiparesis and due to the extent of the tumor encroaching through the brain parenchyma, patient was noted to have seizure episodes. The patient was given surgical and radiologic options however, she did not comply and died last December 2015.RESULTS: A cranial MRI with MRA showed a heterogenous enhancing intracranial mass with extracranial component with compressed entrapped and depressed superior sagittal sinus by the axial mass witin calvarial penetration and scalp involvement compressing on the right parietal lobe with parenchyma edema. Biopsy was eventually done and findings were consistent with an eccrine carcinoma.CONCLUSION: This is the first case of eccrine carcinoma in our institution. Due to the paucity of data, there are no guidelines to the management of an eccrine carcinoma. Hence the imperative need to raise awareness regarding this rare tumor because, without a high index of suspicion this rare entity may be overlooked or misdiagnosed. When presented with an indolent invasive recurrent tumor a high index of suspicion that an eccrine Carcinoma may be suspected.Excision biopsy may be done for correct identification of the tumor.
Subject(s)
Humans , Female , Aged , Scalp , Superior Sagittal Sinus , Seizures , Sweat Gland Neoplasms , Biopsy , Skin Neoplasms , Carcinoma, Skin Appendage , Brain , Edema , Paresis , Parietal LobeABSTRACT
@#<p style="text-align: justify;"><strong>INTRODUCTION:</strong> Eccrine carcinoma is an extremely rare skin tumor where only 1/13000 specimens have been submitted to dermatopathological laboratories in the United States.There is no data yet to compare the Philippines with the international incidence of eccrine carcinoma. This is a case of a 69-year-old Filipino female who presented with a recurring invasive indolent tumor at the right fronto-parietal area who presented with left sided hemiparesis and seizure.<br /><strong>CASE:</strong> The patient was presented with a recurrent invasive indolent mass on her right front-parietal area, grossly measuring five by four centimeters, nodular flesh colored,which extended intracranially.This was associated with left sided hemiparesis and due to the extent of the tumor encroaching through the brain parenchyma, patient was noted to have seizure episodes. The patient was given surgical and radiologic options however, she did not comply and died last December 2015.<br /><strong>RESULTS:</strong> A cranial MRI with MRA showed a heterogenous enhancing intracranial mass with extracranial component with compressed entrapped and depressed superior sagittal sinus by the axial mass witin calvarial penetration and scalp involvement compressing on the right parietal lobe with parenchyma edema. Biopsy was eventually done and findings were consistent with an eccrine carcinoma.<br /><strong>CONCLUSION:</strong> This is the first case of eccrine carcinoma in our institution. Due to the paucity of data, there are no guidelines to the management of an eccrine carcinoma. Hence the imperative need to raise awareness regarding this rare tumor because, without a high index of suspicion this rare entity may be overlooked or misdiagnosed. When presented with an indolent invasive recurrent tumor a high index of suspicion that an eccrine Carcinoma may be suspected.Excision biopsy may be done for correct identification of the tumor.</p>
Subject(s)
Humans , Female , Aged , Scalp , Superior Sagittal Sinus , Seizures , Sweat Gland Neoplasms , Biopsy , Skin Neoplasms , Carcinoma, Skin Appendage , Brain , Edema , Paresis , Parietal LobeABSTRACT
Syringoid eccrine carcinoma (SEC) is a rare cutaneous malignant tumor thought to be derived from eccrine sweat apparatus. It is usually present in the head, neck and trunk region, and often occurs in the fourth to seventh decades of life. A 94-year-old male patient visited our department with an 80-year history of a lesion showing a 2×2 cm sized well-demarcated round shaped erythematous to pinkish colored nodule with ulcer on his left thigh. Histological findings revealed a tumor consisted mainly of numerous small cords and nests forming luminal or tubular structures and tumor cells showing variable atypia. Some ductal structures showed tadpole appearance. On immunohistochemical staining, epithelial membrane antigen, S-100, cytokeratin 7 and carcinoembryonic antigen were reactive and Ki-67 showed less than 10% positivity. Based on these findings, the final diagnosis was made as SEC. The patient was treated with local wide excision and didn't show any recurrence during the follow-up period of 12 months. Herein, we report a very rare case of SEC which occurred on the left thigh and discuss 10 cases of SEC presented on the extremities, including our case.
Subject(s)
Humans , Male , Carcinoembryonic Antigen , Diagnosis , Extremities , Follow-Up Studies , Head , Keratin-7 , Larva , Mucin-1 , Neck , Phenobarbital , Recurrence , Sweat , Sweat Gland Neoplasms , Thigh , UlcerABSTRACT
Epidermodysplasia verruciformis (EV) is a rare, life-long heritable disease caused due to a unique susceptibility to human papilloma virus. The disseminated verrucous lesions and pityriasis versicolor-like lesions persist from early childhood and can transform into a cutaneous malignancy in a fourth of patients. Malignant transformation into syringoid eccrine carcinoma (SEC) has been reported only once so far. SEC is an extremely invasive, rare, locally destructive, slowly growing adnexal tumor. We hereby report the association of EV with SEC in a 29-year-old male.
Subject(s)
Adult , Carcinoma, Skin Appendage/complications , Carcinoma, Skin Appendage/pathology , Cell Transformation, Neoplastic , Epidermodysplasia Verruciformis/complications , Epidermodysplasia Verruciformis/pathology , Humans , Male , Papillomaviridae , Sweat Gland Neoplasms/complications , Sweat Gland Neoplasms/pathologyABSTRACT
Syringoid eccrine carcinoma (SEC) is a rare adnexal tumor with some controversy surrounding its correct definition. It may also be difficult to differentiate from its benign counterpart (syringoma), other adnexal carcinomas, and cutaneous metastasis from adenocarcinomas. Histologically, the tumor is characterized by syringoma-like tadpole morphology composed of basaloid cells with ductular differentiation. However, the tumor cells are deeply invasive and often extend to subcutaneous tissue, which distinguishes this malignancy from syringoma. Moreover, the tumor cells may rarely show striking vacuolization due to intracytoplasmic glycogen accumulation, called clear cell syringoid eccrine carcinoma. To our knowledge, no case of clear cell SEC in Korea has ever been reported. Herein, we present a case of a SEC (of the clear cell variant) complemented with an immunohistochemical study, the latter revealing cytoplasmic accumulation of glycogen and the presence of intercellular and intracellular lumina in clear tumor cells, as well as diverse hallmarks of SEC.
Subject(s)
Adenocarcinoma , Complement System Proteins , Cytoplasm , Glycogen , Immunohistochemistry , Korea , Larva , Neoplasm Metastasis , Strikes, Employee , Subcutaneous Tissue , SyringomaABSTRACT
PURPOSE: Mucinous eccrine carcinoma of the skin is rare skin adnexal malignant tumor, which most commonly occurs in the head and neck regions. This tumor, although rarely metastatic, has a high incidence of local recurrence. We report a case of mucinous eccrine carcinoma developed on the Lt. cheek which was treated by Mohs surgery. METHODS: The patient was a 53-year-old man who showed a palpable skin-colored 1.5 x 1.5cm sized mass on Lt. cheek. We treated it by wide excision, but it recurred several times on the same region. So we finally did the Mohs surgery and full thickness skin graft. RESULTS: The histologic characteristics are large mucinous pools with fibrous septae and clusters of tumor cells. Special stains showed that the mucin was positive reactivity on Periodic acid Schiff. Also the immunocytochemical studies showed a positive reactivity to carcinoembryonic antigen, S-100 protein, cytokeratin-7. Therefore pathologist reported it as a mucinous eccrine carcinoma. CONCLUSION: Authors experienced a rare case of primary mucinous eccrine carcinoma on Lt. cheek which had recurred several times. Because of the high local recurrence rate, we did the Mohs surgery and got an good result. Therefore the early Mohs surgery would be a good choice to primary mucinous eccrine carcinoma.
Subject(s)
Humans , Middle Aged , Carcinoembryonic Antigen , Cheek , Coloring Agents , Head , Incidence , Keratin-7 , Mohs Surgery , Mucins , Neck , Periodic Acid , Recurrence , S100 Proteins , SkinABSTRACT
Mucinous eccrine carcinoma of the skin is a rare skin adnexal malignant tumor that origins from mucin-secreting dark cells, and it arises from the deepest portion of eccrine ducts. It usually affects people in their fifth to seventh decades of life and it predominantly occurs in men. It appears to exhibit a predilection for the head and neck. The histopathologic characteristics are a large mucinous pool with fibrous septae and clusters of tumor cells. The treatment of choice is surgical removal. We present here the case of a patient with a mucinoous eccrine carcinoma on the infraorbital area of the right side of his face and we review the related literature
Subject(s)
Humans , Male , Head , Mucins , Neck , SkinABSTRACT
Cutaneous mucinous eccrine carcinoma is a rare malignant tumor that is presumably of an eccrine gland origin. We observed a 53-year-old man with an erythematous nodule on his left infraorbital area. A large mucinous pool and characteristic tumor cells were shown on H&E stain, and further specific immunohistochemical stains confirmed the diagnosis. We report here on a case of mucinous eccrine carcinoma and we review the relevant literature.
Subject(s)
Humans , Middle Aged , Coloring Agents , Eccrine Glands , MucinsABSTRACT
Syringoid eccrine carcinoma is a rare adnexal tumor of eccrine origin, and has metastatic potential and high recurrence rate following conventional surgical excision. Mohs micrographic surgery has been commonly used for various malignant skin cancers to minimize the defect after surgery, and to decrease the recurrence rate. We present a case of syringoid eccrine carcinoma successfully treated by Mohs micrographic surgery.
Subject(s)
Mohs Surgery , Recurrence , Skin NeoplasmsABSTRACT
Primary mucinous carcinoma is a rare malignant tumor that arises from the deepest portion of the eccrine duct. This tumor consists of large mucinous pool with fibrous septae and clusters of tumor cells. Immunohistochemical staining was studied for the differentiation, but has only limited value. We present a case of mucinous eccrine carcinoma in 56-year-old man and review the literature.
Subject(s)
Humans , Middle Aged , Adenocarcinoma, Mucinous , MucinsABSTRACT
Primary mucinous eccrine carcinoma(MEC) of the skin, one of sweat gland tumor, is a rare. These tumors usually occur in one's fifties and seventies, and are characterized by the secretion of mucin that usually forms the pools surrounding the clusters of tumor cells. The common sites are the eyelids and medial canthus. Pathologically it is difficult to distinguish between primary mucionus carcinoma and metastatic cancers from breast, rectum, colon, bronchus, kidney, ovary, stomach, lacrimal glands, salivary glands, and paranasal sinuses. Therefore study for primary focus is needed. A 62-year-old mand has had a mass on left lower eyelid skin without palpable neck lymph nodes for about five years. In a fine needle aspiration, there were tumor cells floating in a mucin pool. The authors examined several tests including complete blood cell count, liver function test, renal function test, urinalysis, electrocardiography, VDRL, TPHA-S, chest X-ray, chest computed tomography(CT), neck CT, abdominopelvic CT, etc. All the tests showed the origin was the skin. It is diagnosed to primary MEC on skin. The tumor was treated by wide excision with 0.5cm in safe margin and full thickness skin graft was done. There has been no recurrence 10 months after operation.
Subject(s)
Female , Humans , Middle Aged , Biopsy, Fine-Needle , Blood Cell Count , Breast , Bronchi , Colon , Electrocardiography , Eyelids , Kidney , Lacrimal Apparatus , Liver Function Tests , Lymph Nodes , Mucins , Neck , Ovary , Paranasal Sinuses , Rectum , Recurrence , Salivary Glands , Skin , Stomach , Sweat Glands , Thorax , Transplants , UrinalysisABSTRACT
Primary mucinous eccrine carcinoma(MEC) of the skin is a rare adnexal tumor, presumably of eccrine origin, which most commonly occurs in the head and neck regions. These tumors, although rarely metastatic, have a high incidence of local recurrence. We examined the case of a patient with primary MEC of the left lower lateral eyelid. The tumor was treated by Mohs surgery, fresh-tissue technique. There was no recurrence after 2 years of follow-up.
Subject(s)
Humans , Eyelids , Follow-Up Studies , Head , Incidence , Mohs Surgery , Mucins , Neck , Recurrence , SkinABSTRACT
Eccrine carcinoma does not have a characteristic clinical appreranc, but does have a high incidence of metastatic spread. It may arise anywhere in the skin. The microscopic patterns that of an adenocarcinoma, which may be confused with metastatic adenocarcinoma. In the classical type the histologic features varies from fairy well-differentiated tubular structures in some areaslo anaplastic carcinoma in other areas. The patient was a 51-year-old man who showed a painful, tender, right red-calored, 4 x 5crn-sized tumor mass on the right angle of the lower lip for ten years. In the diological examinations multiple metastatic foci were seen on both lung fields, Histopathologic findings of the skin and lung biopsy specimens revealed that of the classic type of eccrine carcinoma like the bove descriptions. Immunocytochemical studies showed a positive reactivity to anti-cytokeratin anti-ibody, anti-CEA antibody, and anti-S-100 protein on the skin and lung biopsy specimens and no he reactivity to anti-S-100 protein on the lung mass. Electronrnicroscopic findings revealed eccrine glaidlar structures such as nunierous mitochondria and dense core granules in the cytoplasm of neoplastic cells. We report a case of eccririe carcinoma with lung metastases baed on the clinical, radiological and histologic findings.
Subject(s)
Humans , Middle Aged , Adenocarcinoma , Biopsy , Carcinoma , Cytoplasm , Incidence , Lip , Lung , Mitochondria , Neoplasm Metastasis , SkinABSTRACT
A primary skin adenoid cystic carcinoma first described by Boggio in 1975, is one of the rarest type of eccrine sweat gland carcinoma. Histologically, a tumor with typical morphologic features closely resembles adenoid cystic carcinoma was found in other tissues but in the skin must be distinguished from aggressive basal cell carcinoma. The natural history of this tumor is not yet fully determined but suggests a long indolent and progressive course. We report a case of a 77-year-old male with a small skin nodule in the abdomen.