Carcinosarcoma ex eccrine spiradenoma of the vulva: report of the first case.

Carcinosarcoma is exceedingly rare in the vulva. We describe a case of carcinosarcoma in a 67-year-old female patient who presented with recent enlargement and pain of a vulval nodule noted for 15 years. The excised tumor showed intermixed carcinomatous (adenocarcinoma and anaplastic carcinoma) and sarcomatous elements (osteosarcoma, chondrosarcoma, and leiomyosarcoma), which focally merged with several lobules of typical eccrine spiradenoma. The inguinal lymph nodes showed metastasis of the carcinomatous component only. This case represents the first reported case of vulval carcinosarcoma of the skin adnexal origin, and has to be distinguished from sarcomatoid carcinoma of epidermal origin because of a probable more aggressive behavior.

Eccrine syringofibroadenoma treated with a dual pulse width flashlamp pumped pulsed dye laser.

BACKGROUND: Eccrine syringofibroadenoma is a rare benign eccrine ductal proliferation with a predilection for the extremities, most often found in middle-aged and elderly patients. Reported treatments have included excision and conventional destructive modalities; however, recurrences may be common. OBJECTIVE: We describe a patient with a chronic ulcerated verrucoid eccrine syringofibroadenoma that persisted despite cryotherapy or curettage and electrodessication. RESULTS: Treatment with a dual pulse width flashlamp pumped pulsed dye laser (FPDL) produced an excellent clinical response. CONCLUSION: Treatment of eccrine syringofibroadenoma with a FPDL may provide both a vascular specific injury, analogous to the treatment of verruca vulgaris, and nonspecific thermal destruction at high fluences.

[Malignant acrospiroma with "zoster-like" clinical expression]. / Acrospiroma maligno ad espressione clinica "zosteriforme".

The diagnostic category "malignant acrospiroma" includes acrosiryngeal-derived sweat gland malignant neoplasms. Many terms are usually employed to indicate different histologic types of such tumours, lacking a definitive classification. We describe a patient suffering from malignant acrospiroma (malignant poroma) with unusual clinico-evolutive presentation.

The role of radiotherapy in the treatment of malignant sweat gland neoplasms.

Malignant sweat gland neoplasms are rare tumors. Historically, the principal mode of treatment has been local surgical excision. Eight published studies show that greater than 50% of patients develop either local tumor recurrence after surgery or regional lymph node metastases. Most patients have evidence of locoregional failure before distant metastases are detected. Three patients were recently referred to the University of Arizona Cancer Center for consideration of irradiation after resection of such tumors. In two patients, the tumor was located on the scalp and, in one patient, on the alar surface of the nose. Their ages ranged from 19 to 60 years. All underwent surgical resection followed by high-dose irradiation of the surgical bed (approximately 70 Gy) and regional lymphatic chains (approximately 50 Gy). Two patients remain disease-free at 27 and 35 months, respectively, after completion of treatment; the third died of rapidly progressive systemic metastases. A review of the literature is provided focusing on treatment success and predominant patterns of recurrence. Finally, a rational approach for evaluation of patients that might benefit from local irradiation is presented.