Modified Mohs micrographic surgery for the treatment of five cases of eccrine porocarcinoma / 中华皮肤科杂志

Objective:To investigate the efficacy of modified Mohs micrographic surgery in the treatment of eccrine porocarcinoma.Methods:Clinical data were collected from 5 patients with eccrine porocarcinoma, who treated with modified Mohs micrographic surgery in Department of Dermatology, Wuhan No.1 Hospital from 2016 to 2020, and retrospectively analyzed.Results:Among the 5 patients, 2 were males and 3 were females, their age ranged from 52 to 80 years, and the course of disease ranged from 1 to 50 years. Skin lesions were located on the scalp, face, abdomen, thighs and feet, with diameters ranging from 1 to 6 cm. Tumor excision was performed with 1-cm margins, and was deep to the superficial fascial layers. For histopathologically negative surgical margins, the defects were closed with skin flaps or grafts; for histopathologically positive margins, the excision margin continued to be widened until it was clean. The 5 patients were followed up for 1 - 5 years without recurrence, and 1 died 2 years later due to liver cancer metastasis.Conclusion:Modified Mohs micrographic surgery can ensure clean resection margins and reduce the loss of normal tissues in the treatment of eccrine porocarcinoma.

A case of recurrent porocarcinoma of the scalp requiring scalp reconstruction

Eccrine porocarcinoma (EPC) is a rare malignant tumour, first reported by Pinkus and Mehregan in 1963. It can develop from the eccrine duct epithelial component or transform from an underlying eccrine poroma. The tumor usually presents as an exophytic growth and has a female predilection. Rarely it can occur in scalp, face, ear, genitalia and eye lids. Treatment modalities have included standard excision, Mohs micrographic surgery, chemotherapy, and radiation therapy. Therapy of choice is surgical excision with clear margins with 70-80% cure rates. Chemotherapy is of no known significance and radiation might help in selective cases. Majority of cases are managed with excision and closure of defects but in selective cases there may be need to reconstruct the scalp defects. The methods of reconstruction may be local flaps, free tissue transfer and partial/full thickness skin grafts. Regional flaps are very useful in patients requiring cover of large defects.

Eccrine porocarcinoma from the abdominal wall in an elderly female: a case report

Eccrine porocarcinoma (EPC) is a rare malignancy arising from the sweat gland. It is commonly seen in elderly female patients. There is no characteristic appearance for this malignancy and so making a clinical diagnosis is difficult. The diagnosis is confirmed by histopathological examination (HPE). Authors present a case of a 53-year-old female who presented with an ulceroproliferative lesion on the left side of the abdominal wall. After the lesion was radiologically ascertained to be localized and having a diagnosis of porocarcinoma from wedge biopsy, a wide local excision was done.  The HPE confirmed the diagnosis of EPC.

Porocarcinoma ecrino metastásico / Metastatic eccrine porocarcinoma

Presentamos el caso de un paciente varón de 69 años, con lesión tumoral en región inguinal izquierda, asintomática. El estudio histopatológico e inmunohistoquímico fue consistente con porocarcinoma ecrino. A la realización de imágenes se evidenció metástasis ganglionares en región iliaca femoral, retroperitoneal y supraclavicular izquierda. Se confirmó infiltración de porocarcinoma ecrino en ganglio supraclavicular al estudio histopatológico. El porocarcinoma ecrino metastásico es de muy rara presentación. El tratamiento quirúrgico no es posible en estos casos. No existe un tratamiento estándar sistémico, solo series de casos con respuestas variables. Nuestro paciente recibió tratamiento sistémico con docetaxel con buena tolerancia.

We present the case of a 69-year-old male patient with tumor lesion in the left inguinal region, asymptomatic. The histopathological and immunohistochemical study was consistent with ecrine porocarcinoma. Upon imaging, nodal metastases in the iliac femoral, retroperitoneal and supraclavicular left region are evident. Ecrine porocarcinoma infiltration into supraclavicular ganglion is confirmed at histopathological study. Metastatic eccrine porocarcinoma is very rare. Surgical treatment is not possible in these cases. There is no standard systemic treatment, only case series with variable responses. Our patient received chemotherapy treatment with doxetacel with good clinical response to follow-up.

The transition between a poroma and a porocarcinoma evidenced by the dermoscopy

Abstract Eccrine porocarcinoma (EPC) is a rare malignant skin tumor. The dermoscopy of invasive EPC reveals focal presence of whitish-pink, structureless areas surrounded by pinkish-white halos. In an eccrine poroma (EP), such areas present diffuse distribution in the "frog- eggs" pattern. We reported an EPC in situ that presents a transitional dermoscopy pattern between EP and invasive EPC. We found a diffuse distribution; whitish-pink, structureless areas surrounded by pinkish-white halos; a central exulceration and a polymorphic vascular pattern.

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.

A Case of Malignant Hidracanthoma Simplex Showing Borst-Jadassohn Phenomenon / 대한피부과학회지

No abstract available.

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 / 中华病理学杂志

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.

Concomitant poroma and porocarcinoma

Abstract: Eccrine poromas and porocarcinomas are adnexal tumors derived from the sweat duct epithelium. However, eccrine poroma is benign in nature, whilst eccrine porocarcinoma is regarded as its malignant counterpart. We report the case of a man who presented simultaneously with an eccrine poroma and eccrine porocarcinoma. Both lesions had no clear distinctive features, enhancing the need of high-level clinical suspicion together with surgical excision and histopathology for prompt diagnosis confirmation.

Porocarcinoma Ecrino / Ecrine Porocarcinoma

Resumen:El porocarcinoma ecrino es un tipo muy poco frecuente de cáncer de piel, originado en la porción epidérmica de las glándulas sudoríparas ecrinas. Representa no más del 0.01% de los tumores cutáneos. El 20% de los porocarcinomas ecrinos son recurrentes y el 20% producen metástasis a ganglios linfáticos. Se ha reportado escasos casos de metástasis a distancia. Tiene un índice de mortalidad del 67% de los pacientes con metástasis.El diagnóstico es basado en los hallazgos histopatológicos y los estudios complementarios de inmunohistoquímica, a veces necesarios para el diagnóstico diferencial con otros tipos más frecuentes de cáncer de piel.No existen pruebas de que este tipo de carcinoma responda a la quimioterapia ni la radioterapia. Se considera que el manejo principal debe ser la resección quirúrgica y la electroquimioterapia.

Abstract:Eccrine porocarcinoma is a rare type of skin cáncer arising from the intraepidermal portion of eccrine sweat glands, representing no more tan 0.01% of all cutaneous tumors. 20% of the Eccrine porocarcinoma will recur and 20% will metastasize to regional lymph nodes. Few cases of distant metastases has been reported . There is a mortality rate of 67% in patients with metastases. The diagnosis is primarily based on histopathologic findings and complementary immunohistochemistry for differential diagnosis mainly with more frequent skin cáncer.Neither chemotherapy nor radiation therapy has been proven to be of clinical benefit in treating this type of carcinoma. It is considered that the management should be based on surgical resection and electrochemotherapy.

Hidroacanthoma simplex: dermoscopy and cryosurgery treatment

Abstract: Hidroacanthoma simplex is a rare intraepidermal neoplasia that arises from the acrosyringial portion of the eccrine duct. Malignant transformation of hidroacanthoma simplex is reported in the literature and the treatment is performed with wide excision or Mohs micrographic surgery. We report the first case successfully treated with cryosurgery with a long-term follow up.

Porocarcinoma Arising in a Ganglion Cyst: A Case Report and Review of the Literature

Eccrine porocarcinoma is a rare malignant neoplasm of the eccrine sweat gland that often occurs in the lower extremities, and usually affects elderly individuals. Most cases of eccrine porocarcinoma arise de novo. We encountered a case of a large porocarcinoma arising in a pre-existing ganglion cyst in the knee. The malignant tumor was excised widely, and the defect was reconstructed using a free anterolateral thigh flap.

Eccrine poroma and porocarcinoma on the same unusual location: report on two cases

Eccrine poroma is a benign adnexal tumour of the uppermost portion of the intraepidermal eccrine sweat gland duct and acrosyringium. Eccrine porocarcinoma is the malignant phenotype arising from the intraepidermal portion of the eccrine sweat gland duct epithelium or from pre-existing eccrine poroma. Both commonly occur in the palms or sides of the feet; these areas have a high concentration of eccrine sweat glands. We describe two respective cases of benign and malignant eccrine poroma on the scrotum, which entailed good excisional results.

Tumores cutâneos raros em cabeça e pescoço: experiência de 4 anos em uma instituição terciária / Head and neck rare skin tumors: 4 years of experience in a tertiary institution

Introdução: O câncer de pele é o mais incidente dentre as neoplasias. Os tipos histológicos mais comuns são Carcinoma Basocelular (CBC), Carcinoma Espinocelular (CEC) e, menos frequente, o Melanoma. Geralmente acometem segmentos corporais expostos aos raios ultravioletas, principalmente a região de cabeça e pescoço. Porém, há outros tipos mais de tumores que acometem esta área e que fazem parte da prática da oncologia cutânea encaminhada aos cirurgiões de cabeça e pescoço. Objetivo: O objetivo deste trabalho é descrever estas neoplasias percutâneas raras que foram operadas no Instituto do Câncer do Estado de São Paulo (ICESP) nos últimos 4 anos. Resultados: As entidades Carcinoma de células de Merkel, Dermatofibrossarcoma protuberans, Angiossarcoma, Fibroxantoma atípico, Porocarcinoma, Carcinoma triquilemal, Carcinoma de células claras, Carcinoma sarcomatoide e Carcinoma apócrino compuseram 4,4% dos atendimentos de oncologia cutânea realizada pela Cirurgia de Cabeça e Pescoço. Uma breve revisão de cada entidade foi realizada. Discussão: A compreensão dos tipos histológicos raros é importante no tratamento de tumores cutâneos na prática da cirurgia de cabeça e pescoço.

Introduction: Skin cancer is the most frequent cancer among neoplasms. The most common histological types are Basal Cell Carcinoma (BCC), Squamous Cell Carcinoma (SCC) and, less frequent, Melanoma. They generally affect body segments exposed to ultraviolet rays, especially the head and neck region. However, there are other types of tumors involving this area and they are part of the practice of cutaneous oncology referred to head and neck surgeons. Objective: The objective of this paper is to describe these rare cutaneous neoplasms, which were treated at the Instituto do Câncer do Estado de São Paulo (ICESP) in the last 4 years. Results: Merkel cell carcinoma, Dermatofibrosarcoma protuberans, Angiosarcoma, Atypical Fibroxanthoma, Porocarcinoma Trichilemmal carcinoma, Sarcomatoid carcinoma and Apocrine carcinoma comprised 4.4 % of cases of cutaneous oncology conducted by Head and Neck Surgery. A brief review of each neoplasm was performed. Discussion: understanding of the rare histological types is important in the treatment of skin tumors in the practice of head and neck surgery.

Porocarcinoma ecrino: estudio clínico-patológico de 19 casos en el instituto nacional de enfermedades neoplásicas, Lima - Perú / Eccrine porocarcinoma: clinical-pathological study of 19 cases in the instituto nacional de enfermedades neoplásicas, Lima - Peru

Con el objetivo de describir las características clínico-patológicas de los casos de porocarcinoma ecrino (PE) registrados en el Instituto Nacional de Enfermedades Neoplásicas (INEN), se realizó un estudio trasversal que incluyó todos los casos entre 1998-2009. Para ello se realizó una revisión de fichas clínico-patológicas y una nueva lectura de las láminas de patología de los casos encontrados. Se hallaron 19 casos de PE; la mediana de edad fue de 64 años (rango: 37-98); con mayor frecuencia en el sexo masculino (57,9%); la localización más frecuente fue en el pie (21,1%), seguida de cabeza, tórax y muslo (15,8%, en todos los casos). Se describe un caso de localización glútea que cursó con una conducta inusualmente invasiva y con compromiso rectal. Se concluye que el PE es una entidad poco frecuente en el Perú, su localización más común es en el pie, y afecta predominantemente al sexo masculino.

In order to describe the clinical-pathological characteristics of the cases of Eccrine Porocarcinoma (EP) found in the Instituto Nacional de Enfermedades Neoplásicas (INEN), a cross-sectional study was carried out, including all EP cases recorded between 1998 and 2009. A revision of the clinical-pathological records indentified and a new reading of the pathology slides of the cases found were performed. 19 EP cases were found, the median age of which was 64 years (range: 37-98). EP was primarily found on male patients (57.9%) and was most commonly located on the foot (21.1%), followed by the head, thorax and thigh (15.8%, respectively). In one case, EP was located on the gluteal region, and showed an unusually invasive behavior and rectal involvement. We conclude that EP is a rather uncommon entity in Peru. Its most common location is on the foot and it affects mostly male patients for the most part.

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.

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.

Eccrine Porocarcinoma

Eccrine porocarcinoma is an extremely rare malignant cutaneous neoplasm. This tumour has an indolent behavior and misleading clinical diagnosis often leading to a delay in definitive treatment. The definitive diagnosis is made by histopathology since clinical findings often vary. The tumour must be considered in the differential diagnosis of elderly patients presenting with long standing skin lesion with a recent history of accelerated growth rate. Because of its reported high rate of local recurrence, a wide excision of the tumour with clear resection margins is mandatory. Close long term follow up is required. We present herein two cases of eccrine porocarcinoma.