Endocrine mucin-producing sweat gland carcinoma and associated primary cutaneous mucinous carcinoma: Review of the literature.

BACKGROUND: Endocrine mucin-producing sweat gland carcinoma (EMPSGC) is a rare, low-grade, cutaneous adnexal carcinoma with neuroendocrine differentiation. It is considered to be a precursor of invasive neuroendocrine type primary cutaneous mucinous carcinoma (PCMC). OBJECTIVE: To review clinicopathological literature summary of EMPSGC and associated neuroendocrine PCMC from all reported cases and compare its behavior vs non-neuroendocrine PCMC data reported in the literature. METHODS: A review of English literature of all EMPSGC cases with and without associated PCMC was carried out. RESULTS: EMPSGC was associated with invasive neuroendocrine type PCMC in 35.7% of cases. We found the recurrence rate of PCMC associated with EMPSGC of about 12.3%, which is much less than the 30% recurrence rate reported for the non-neuroendocrine subtype of PCMC. The non-neuroendocrine subtype of PCMC shows a 4% and 11% rate of distant and lymph node metastasis, respectively, vs EMPSGC-associated neuroendocrine type of PCMC, which is very indolent and only one recent case of locoregional metastasis out of 190 EMPSGC cases has been reported so far. LIMITATION: Limitation of our study includes data derivation from case reports and case series in the literature. CONCLUSION: The prognostic benefits for this cohort of patients may be considered in their overall management.

Chondroid Syringoma of a Cheek.

Chondroid syringoma is an unusual, benign skin appendageal tumor originating from the eccrine and apocrine sweat glands resembling mixed tumors of the salivary glands. It develops as a slow-enlarging, small, cutaneous nodule or mass. The lesions are usually seen in older men on head and neck. This is a clinical report of a 46-year-old lady who presented with a slowly growing nodular protruding mass in a cheek. The clinical and histologic findings of the tumor are demonstrated. The clinician and the pathologist should take into account the tumor among differential diagnosis not to overlook the lesion. Total surgical excision is needed with a long-term follow-up.

Axillary syringomas.

Syringomas are common benign neoplasms encountered mostly around the eyes. However, as described herein, these tumors can occur in atypical locations such as the axilla. The differential diagnosis revolves around those entities more likely seen in this anatomical location (such as Fox-Fordyce, Hailey-Hailey and Darier diseases). Various ablative modalities are curative.

Pigmented eccrine poromas: expression of melanocyte-stimulating cytokines by tumour cells does not always result in melanocyte colonization.

BACKGROUND: Although eccrine poroma (EP) occurs preferentially in palmoplantar areas, pigmented variants of EP have not been documented on the palms and soles. OBJECTIVES: We seek to confirm the notion regarding lack of pigmented EP on palmoplantar areas and determine whether the absence of pigmentation in palmoplantar EPs is due to lack of expression of melanocyte-stimulating cytokines by tumour cells. METHODS: We searched the PubMed and Web of Science databases (1966-2006) for reports of pigmented EPs. In addition, a total of 17 EPs were collected from our pathology department. The presence of melanin was examined with haematoxylin-eosin sections, and melanocyte colonization was shown by immunohistochemical stains for tyrosinase. In addition, immunohistochemical staining with antibodies to melanocyte-stimulating cytokines, including endothelin-1, stem cell factor, and nerve growth factor, was done on these tumours. RESULTS: A review of the literature revealed 15 pigmented EP reports, none of which were located in palmoplantar areas. Among 17 EPs collected from our pathology department, 7 occurred in palmoplantar areas and 10 in non-palmoplantar areas. Three of the palmoplantar EPs and three of the non-palmoplantar EPs showed positive staining with melanocyte-stimulating cytokines. However, none of the palmoplantar EPs contained melanocytes or melanin pigment, wheras the three non-palmoplantar EPs that stained positively with melanocyte-stimulating cytokines were colonized with melanocytes and showed pigmentation clinically. CONCLUSIONS: The expression of melanocyte-stimulating factors by tumour cells is associated with melanocyte colonization in non-palmoplantar EPs but not palmoplantar EPs. Therefore, the presence of melanocyte-stimulating cytokines per se is not sufficient by itself to induce melanocyte colonization. Certain characteristics of palmoplantar skin, such as the dermal components of these anatomical sites, may play a role in inhibiting melanocyte colonization of EPs.

Eccrine poroma: a differential diagnosis in chronic foot lesions.

Eccrine poroma is a benign tumor which arises from the intraepidermal portion of the eccrine sweat glands. It usually occurs as a solitary lesion in the extremity, with the foot and sole as a common site. It may present as a foot mass, ulcerative lesion, bleeding lesion, or suspected melanoma. The clinical diagnosis is often delayed or inaccurate. Three cases of eccrine poroma on the foot are presented. The clinical and histological features, problem in diagnosis, chance of recurrence, and potential transformation to eccrine porocarcinoma are discussed. It is emphasized that eccrine poroma should be considered in the differential diagnosis of chronic foot lesions. Complete excision prevents recurrence, excludes dysplastic change, and prevents future malignant change.

Small cell sweat gland carcinoma in childhood.

Sweat gland carcinomas are rare skin tumors that typically occur in older patients. The spectrum of their clinical and pathologic features is broad, and many different types of sweat gland carcinomas have been described, ranging from fairly indolent to highly aggressive neoplasms. We present two cases of sweat gland carcinoma with a predominant small cell morphology. Both tumors occurred in children. One lesion developed in an 8-year-old girl as an asymptomatic papule on her left forearm, which ultimately was evaluated using biopsy because of rapid growth and change in color. The other lesion occurred on the hand of a 12-year-old boy. Both tumors were pandermal and extended into fat. They were composed of monotonous cuboidal cells with scant cytoplasm that formed tubules and grew in anastomosing cords and trabeculae. The tumor cells were immunoreactive for cytokeratins but not for cytokeratin 20. Ultrastructural analysis (available in one case only) showed that the tumor cells lacked neurosecretory granules. This variant of sweat gland carcinoma needs to be distinguished from other small cell neoplasms of the skin, especially Merkel cell carcinoma, its closest mimic.

A case of eccrine poroma with multiple transepidermal elimination.

The skin functions to eliminate foreign substances through the epidermis to the epidermal surface; this process is called transepidermal elimination (TEE). TEE has been observed in various skin tumors. We encountered a 64-year-old male patient with eccrine poroma with marked TEE. A dark brown nodular papule appeared on the anterior aspect of his right leg about 20 years ago and gradually expanded. Histopathologically, cell nests of poroma were extruded to the epidermal surface at several sites. No erosion was noted, and mild to moderate inflammatory cell infiltration was observed in the upper layer of the dermis. According to Mehregan's classification, the TEE, phenomenon observed in our case may correspond to types 2 and 3.

[Collagenolysis above eccrine spiradenoma]. / Collagénolyse au-dessus des spiradénomes eccrines.

BACKGROUND: The casual observation of a peritumoral edema with collagenolysis in a case of eccrine spiradenoma led us to search for similar lesions in a retrospective series of 50 spiradenomas. MATERIAL AND METHODS: Among 50 cases of eccrine spiradenomas, 36 excised with the overlying epidermis and the surrounding dermis were finally available for a conventional histologie study. RESULTS: In 14 cases, i.e. 39p. 100, we observed an edema above the tumour with thin and sparse collagen fibers and less altered elastic fibers. The clinical presentation of these 14 cases was not different from the general presentation of eccrine spiradenomas, but no precise photographical or clinical data were available. DISCUSSION: The cause of this epitumoral collagenolysis is unknown. It seems unrelated to the clear perivascular spaces often observed within the tumour lobules. It is of no help for diagnosis and may be considered as an unexplained curiosity like the elastolysis and the anetoderma seen above some pilomatricomas.

[Sweat gland tumors in Niger. Anatomopathology]. / Tumeurs sudorales au Niger. Etude anatomo-pathologique.

The authors report 15 cases of sweat gland tumour observed over 2 years in Niger where their pathology was never studied. These tumours accounted for 0.38 p. 100 of all examinations performed during the same period at the pathological laboratory of the University of Niamey. They ranked sixth among the diagnoses of skin pathology. Only routine histological techniques were used. The diagnoses obtained could be divided into 5 groups. Eight women presented with partly solid cystic tumours located on the legs in 5 cases; their structure was typical of nodular hidradenoma. Two male patients had cyst-pitted tumours the superficial portion of which showed a structure of papillary eccrine adenoma, while the deep portion contained a multitude of cysts with atrophic walls; the authors consider this type of tumour as a variant of papillary eccrine adenoma. One patient had a syringocystadenoma which also included a large cyst. Finally, one patient presented with a chondroid syringoma in the axillary region, and 3 patients had histologically aggressive carcinomas located on the sole, forehead and axillary region respectively. Clinical and paraclinical investigations failed to detect any deep malignancy in these three patients, and their tumours were regarded as compatible with sweat gland carcinomas. In this series, two lesions were unusually numerous: carcinomas and nodular hydradenomas. The first named probably are a consequence of the socio-economic conditions prevailing in the population of Niger: poverty prevents patients from consulting for diseases which produce no symptoms, which artificially increases the apparent incidence of aggressive lesions. As for nodular hydradenomas, they are large owing to the presence of cysts.(ABSTRACT TRUNCATED AT 250 WORDS)

[Morphology and clinical significance of syringomas of the external auditory canal (author's transl)]. / Morphologie und klinische Wertigkeit der Gehörgangs-syringome

Syringomas of the external auditory canal ("ceruminomas"), are very rare their morphology is varied and their clinical course hardly predictable. Their nomenclature is controversial and easily misunderstood. Two cases of syringomas of the external auditory canal are reported (one adenoma and one adenoid-cystic carcinoma) which were also studied by means of electron microscopy. The morphology and clinical significance of these tumors is discussed.