Assuntos
Antineoplásicos Imunológicos/uso terapêutico , Cetuximab/uso terapêutico , Resistencia a Medicamentos Antineoplásicos/efeitos dos fármacos , Porocarcinoma Écrino/tratamento farmacológico , Imunoterapia/efeitos adversos , Neoplasias das Glândulas Sudoríparas/tratamento farmacológico , Idoso , Porocarcinoma Écrino/imunologia , Porocarcinoma Écrino/metabolismo , Porocarcinoma Écrino/patologia , Receptores ErbB/genética , Receptores ErbB/metabolismo , Humanos , Masculino , Prognóstico , Neoplasias das Glândulas Sudoríparas/imunologia , Neoplasias das Glândulas Sudoríparas/metabolismo , Neoplasias das Glândulas Sudoríparas/patologiaRESUMO
Eccrine porocarcinoma is a rare aggressive cutaneous malignancy. Complete surgical excision is the standard of care, although there are high rates of local and distant recurrence. We present a unique case of locally recurrent and metastatic subungal porocarcinoma successfully treated with intralesional interleukin-2.
Assuntos
Porocarcinoma Écrino , Neoplasias das Glândulas Sudoríparas , Porocarcinoma Écrino/tratamento farmacológico , Humanos , Interleucina-2 , Recidiva Local de Neoplasia , Neoplasias das Glândulas Sudoríparas/tratamento farmacológicoRESUMO
A 67-year-old woman presented in 2012 with a crusty nodule on the left lower limb. Histopathological examination at this time reported a poorly differentiated squamous cell carcinoma (SCC). Two years later, she underwent lymphadenectomy and radiotherapy due to unilateral inguinal and pelvic sidewall nodal metastases. The following year she required excision of two subcutaneous lesions, reported pathologically to be SCC metastases. Further imaging following cyberknife radiotherapy to new brain metastases demonstrated widespread metastatic visceral disease. Twelve cycles of carboplatin and capecitabine failed to halt disease progression. In February 2017, she commenced pembrolizumab, achieving an excellent response and currently has no clinical or radiological evidence of disease. Given the unusual behaviour of her cancer, a histopathological review was requested. The diagnosis was revised to that of porocarcinoma (PC). This represents the first documented case of PC treated with immunotherapy. As of March 2019, the patient remains free of disease.
Assuntos
Anticorpos Monoclonais Humanizados/uso terapêutico , Antineoplásicos Imunológicos/uso terapêutico , Neoplasias Encefálicas/tratamento farmacológico , Porocarcinoma Écrino/tratamento farmacológico , Neoplasias das Glândulas Sudoríparas/patologia , Idoso , Neoplasias Encefálicas/diagnóstico , Neoplasias Encefálicas/secundário , Carcinoma de Células Escamosas/diagnóstico , Erros de Diagnóstico , Porocarcinoma Écrino/diagnóstico , Porocarcinoma Écrino/secundário , Feminino , Humanos , Perna (Membro) , Metástase Linfática , Pelve , Neoplasias Cutâneas/diagnóstico , Neoplasias das Glândulas Sudoríparas/diagnóstico , Resultado do TratamentoRESUMO
This is the first report of a case of porocarcinoma that was successfully treated with maxacalcitol and imiquimod.
Assuntos
Calcitriol/análogos & derivados , Porocarcinoma Écrino/tratamento farmacológico , Imiquimode/administração & dosagem , Neoplasias das Glândulas Sudoríparas/tratamento farmacológico , Idoso de 80 Anos ou mais , Antineoplásicos/administração & dosagem , Calcitriol/administração & dosagem , Porocarcinoma Écrino/patologia , Feminino , Humanos , Neoplasias das Glândulas Sudoríparas/patologia , Resultado do TratamentoRESUMO
BACKGROUND: Eccrine porocarcinoma (EPC) is an uncommon malignant neoplasm that originates in the intraepidermal portion of the eccrine sweat duct. Although porocarcinoma is a slow-growing tumor, up to 20% of cases can metastasize to regional lymph nodes, thus increasing mortality. METHODS: We describe the clinical and histopathological features and clinical course of three cases of extensive metastatic EPC diagnosed in our department over the last 10 years. RESULTS: All three patients were women aged 89-96 years. They had numerous skin tumors on the left leg that were histologically and immunohistochemically diagnosed as metastatic EPC. Only one patient had a history of primary porocarcinoma, which had been excised 6 years earlier. The remaining two patients had a previous lesion diagnosed as squamous cell carcinoma. We treated the patients with palliative radiotherapy and/or chemotherapy. Only one patient is currently alive. CONCLUSIONS: The cases of cutaneous and regional metastatic EPC we present occurred in elderly women with major involvement of the left leg. The third case is noteworthy, as the patient presented a long latency period before metastases appeared. Difficulties in the clinical diagnosis--and occasionally histological diagnosis--of primary EPC could delay more aggressive treatment, although optimal treatment does not always guarantee a good prognosis.
Assuntos
Porocarcinoma Écrino/secundário , Cuidados Paliativos , Neoplasias das Glândulas Sudoríparas/patologia , Idoso de 80 Anos ou mais , Quimiorradioterapia , Porocarcinoma Écrino/tratamento farmacológico , Porocarcinoma Écrino/radioterapia , Feminino , Humanos , Metástase Linfática , Neoplasias das Glândulas Sudoríparas/tratamento farmacológico , Neoplasias das Glândulas Sudoríparas/radioterapiaAssuntos
Ácido Aminolevulínico/uso terapêutico , Porocarcinoma Écrino/tratamento farmacológico , Fotoquimioterapia , Fármacos Fotossensibilizantes/uso terapêutico , Neoplasias Cutâneas/cirurgia , Idoso de 80 Anos ou mais , Biópsia , Porocarcinoma Écrino/patologia , Feminino , Humanos , Perna (Membro) , Neoplasias Cutâneas/patologiaAssuntos
Hidrocarbonetos Aromáticos com Pontes/administração & dosagem , Carboplatina/administração & dosagem , Porocarcinoma Écrino/tratamento farmacológico , Taxoides/administração & dosagem , Parede Abdominal/patologia , Porocarcinoma Écrino/patologia , Humanos , Linfonodos/patologia , Masculino , Pessoa de Meia-Idade , Metástase Neoplásica , Cuidados Paliativos , Glândulas Sudoríparas/efeitos dos fármacos , Glândulas Sudoríparas/patologiaRESUMO
We report the case of an old woman with an eccrine porocarcinoma unusually localized in the perianal area treated by electrochemotherapy, a new technique, emerging as a very effective local treatment of different skin metastases and selected primary tumors. Electrochemotherapy was performed taking into account patient wishes and refusal of demolitive surgery. The electrochemotherapy treatment was well tolerated by the patient, it gave an excellent clinical response and a complete clinical regression with no sphincter dysfunction and signs of relapse observed during follow-up. The case is of particular interest for the exceptional localization of porocarcinoma for the first time treated by electrochemotherapy in this area. Electrochemotherapy could be considered as an alternative option for selected cases of cutaneous tumors.