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Malignant eccrine poroma is a rare malignancy of eccrine glands , whose diagnosis is an index of high suspicion and challenging to a clinician. A case of 67 year old female with swelling over left cheek since 20 years with no radiation exposure and no comorbidities , was investigated and wide local excision with 5mm margins from the tumor was performed , and specimen sent for biopsy - which revealed tumor cells arranged in lobules with peripheral palisading , ductal and squamous differentiation - suggestive of Porocarcinoma.Wide surgical excision is the mainstay of treatment, resulting in cure rates of 70–80% when the margins are clear. Some studies also reported good outcomes with Mohs micrographic surgery, and this technique could also be considered 1. Other treatments such as chemotherapy and radiotherapy have also been reported in the literature without clear standard guidelines
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Background: Troublesome tumors (Skin adnexal tumors (SAT)) pose a major diagnostic difficulties because of their wide spectrum and variants, their rarity, differentiation along two or more adnexal lines and their complicated nomenclature to both the surgeon and the pathologist. Histopathology is the gold standard of diagnosis with immunohistochemistry playing a limited role.Materials and methods: A Prospective study of skin adnexal tumors (n =25) diagnosed on histopathological examination over a period of 2 years (June 2015 to May 2017). All slides were stained with H & E.Results: Majority of the patients are in the third and fourth decade. Females outnumbered the males.Twenty-two tumors are benign and 3 are malignant. Most common skin adnexal tumors are Hair follicle origin tumors comprising of 15cases (60%). In that most common benign tumor is Trichoepithelioma. Head and neck region is the commonest site involved.Conclusion: Skin adnexal tumors are relatively rare. Benign adnexal tumors are more common than the malignant lesions. Histopathology is essential to confirm the diagnosis.
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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.
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Humanos , Neoplasias das Glândulas Sudoríparas , Glândulas Sudoríparas , Poroma , Porocarcinoma ÉcrinoRESUMO
El poroma ecrino (PE) corresponde a una neoplasia anexial benigna originada de la porción intraepidérmica del conducto de las glándulas sudoríparas. Habitualmente se describe como nódulos eritematosos o color piel ubicados en región palmoplantar, pero sus características clínicas son muy variables. Se decriben los hallazgos clínicos y dermatoscópicos de una serie de casos de pacientes con PE. La dermatoscopia puede facilitar significativamente el diagnóstico clínico de la mayoría de los tumores de la piel, sin embargo el PE se caracteriza por un alto grado de variabilidad a la dermatoscopía. Habitualmente se describe un patrón vascula polimorfo con vasos glomerulares, en horquilla, y lineales irregulares con terminaciones semicirculares rodeados de un halo blanco a rosa en forma de caliz o flor de cerezo asociado a áreas rosadas blanquecinas sin estructuras similares a lo observado en melanoma amelanótico, carcinoma espinocelular entre otros tumores benignos y malignos. El PE puede exhibir características clínicas y dermatoscópicas polimórficas que pueden hacer difícil el diagnóstico y su diferenciación de otras neoplasias cutáneas.
Eccrine poroma (PE) is a benign adnexal neoplasm of the intraepidermal portion of the sweat gland duct. PE typically present as erythematous or flesh-colored nodules on the palms and soles, but the clinical features of PE are highly variable. Dermatoscopic and clinical findings of patients with EP are described. Dermoscopy may significantly improves the clinical diagnosis of most skin tumours, but PE is characterised by a high degree of dermoscopic variability. The main dermoscopic features described are polymorphous vascular pattern, whiteto- pink halo surrounding the vessels, pink-white structureless areas, vascular structures of glomerular, hairpin vessels, and linear irregular vessels, mimicking amelanotic melanoma, keratinising tumours and several benign and malignant tumors. Eccrine poroma may exhibit polymorphic clinical and dermoscopic features making it difficult to diagnosis and differentiate from other skin cancers.
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Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Neoplasias Cutâneas/patologia , Neoplasias das Glândulas Sudoríparas/patologia , Poroma/patologia , Neoplasias Cutâneas/diagnóstico , Neoplasias das Glândulas Sudoríparas/diagnóstico , Dermoscopia , Diagnóstico Diferencial , Poroma/diagnósticoRESUMO
Eccrine poroma is described as a benign neoplasm originating from the intraepidermal eccrine duct of sweat glands. This tumor is known to arise in bare skin areas, but more rarely appeared in head and neck region. A 54-year-old female presented with a mass on the retroauricular aspect of the left auricle. There was a soft, protruding, and purple-colored, solitary mass of about 1.0x1.0 cm in size. After authors performed an excisional biopsy, eccrine poroma was confirmed histopathologically. Thus, we report a rare case of eccrine poroma of the ear with the review of literature.
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Feminino , Humanos , Pessoa de Meia-Idade , Biópsia , Orelha , Pavilhão Auricular , Cabeça , Pescoço , Poroma , Pele , Glândulas SudoríparasRESUMO
Burow's graft, obtained from the excised Burow's triangle, is a sort of full-thickness skin graft and can provide outstanding results because the skin used is immediately adjacent to the defects. This procedure is a suitable reconstruction method of surgical defects which are too large for primary closure or within an anatomic subunit with insufficient skin elasticity. Reconstruction of the scalp is not simple owing to lack of elasticity, inflexibility, and hair-bearing feature. We report a case of large sized eccrine poroma on the scalp that was reconstructed with Burow's graft, producing an aesthetically satisfactory result.
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Elasticidade , Poroma , Couro Cabeludo , Pele , TransplantesRESUMO
El poroma ecrino es un tumor benigno anexial raro. Clínicamente se presenta como un nódulo solitario rosado, asintomático, topografiado comúnmente en palmas y plantas. El diagnóstico clínico diferencial más importante se plantea con el melanoma amelanótico. La dermatoscopía ayuda en algunos casos a distinguir entre ellos. Se describe el caso de una paciente de 50 años que se presenta con un nódulo palmar derecho que a la dermatoscopia presenta estructuras vasculares solitarias, glomerulares, con áreas blanco rosadas sin estructuras y pequeñas erosiones. El diagnóstico histopatológico fue de poroma ecrino.
Eccrine poroma is a rare benign adnexal tumor. It usually, presents as an asymptomatic, solitary, pink nodule in palms and soles. Its main differencial diagnosis is amelanotic melanoma. Dermoscopy can improve the differentiation between them. We describe the case of a 50 year-old woman who presented with a nodule in the her right palm which at dermoscopy showed solitary vascular structures, glomerular vessels, pink white structureless areas and little erosions. The histopathologic diagnosis was eccrine poroma.
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Humanos , Feminino , Pessoa de Meia-Idade , Dermoscopia , Neoplasias das Glândulas Sudoríparas/patologia , Poroma/patologia , Acrospiroma , Diagnóstico Diferencial , Neoplasias das Glândulas Sudoríparas/diagnóstico , Poroma/diagnósticoRESUMO
Eccrine poroma is a benign tumor, which is thought to originate from the epidermal eccrine sweat duct unit. It occurs primarily on the hairless acral surface. However, there have been some cases occurring in atypical area like scalp and face. In general, eccrine poroma lacks melanin pigment clinically and melanocytes on microscopic examination. However, in either black or yellow skin, melanin granules and melanocytes can occasionally be found dispersed within the tumor. We report a case of pigmented eccrine poroma occurring on the scalp. The lesion was located on an unusual occurring site as well as contained melanocyte and melanin.
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Melaninas , Melanócitos , Poroma , Couro Cabeludo , Pele , SuorRESUMO
Eccrine poroma is a benign neoplasm, arising from the eccrine sweat duct. It generally occurs in middle aged individuals and is most commonly found on the sole or the sides of the foot, followed by the hands and fingers. It presents as a solitary, soft or a rather firm consistent, sessile or often slightly pedunculating, tumor. A 47-year-old woman presented with a 2.5x1.5 sized brownish to erythematous pedunculating mass on the left flank. According to histopathologic finding and immunohistochemical staining (epithelial membrane antigen), the final diagnosis was consistent with eccrine poroma. We report here on an interesting case of eccrine poroma presenting as pedunculating mass on the flank, which is an unusual location.
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Feminino , Humanos , Pessoa de Meia-Idade , Dedos , Pé , Mãos , Membranas , Poroma , SuorRESUMO
A 40-year-old woman presented with an asymptomatic red to brown colored walnut-sized, dome shaped, hemorrhagic, crusted nodule on the left forearm. There was no previous history of trauma to the area. The first impression of this case was a vascular tumor or malignant lesion due to the large size and bleeding tendency. However, the final diagnosis, according to histologic and immunostaining methods, was a benign eccrine poroma that occurred on the left forearm, which is an unusual area for such a lesion. The tumor was excised and no recurrence was noted when she was examined 24 months later.
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Adulto , Feminino , Humanos , Antebraço , Hemorragia , Poroma , RecidivaRESUMO
Eccrine poroma is a benign neoplasm that originates from an eccrine sweat duct. Although it is most commonly found on the soles of the feet, it has also been unusually observed on many other areas of the skin, such as the nose, neck, chest, and scalp. We report two cases of eccrine poroma occurring on the scalp, which is an unusual location.
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Pé , Pescoço , Nariz , Poroma , Couro Cabeludo , Pele , Suor , TóraxRESUMO
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.
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Idoso , Feminino , Humanos , Agregação Celular , Porocarcinoma Écrino , Glicogênio , Coxa da PernaRESUMO
Eccrine poroma is a benign, rare cutaneous neoplasm that clinically represents as solitary, reddish and pink papule or nodule chiefly on the soles or sides of the feet. But it can occur anywhere wherever sweat glands are found. Eccrine poroma generally arises in the middle-aged and elderly people and do not usually exceed 20 mm in diameter. To the best our knowledge, no congenital cases of eccrine poroma have been reported in the Korean literature. We, herein, report a rare case of eccrine poroma arising on the left temple in a 45-year-old man since birth.