Assuntos
Porocarcinoma Écrino , Neoplasias Cutâneas , Neoplasias das Glândulas Sudoríparas , Humanos , Porocarcinoma Écrino/cirurgia , Pele/patologia , Neoplasias Cutâneas/diagnóstico , Neoplasias Cutâneas/cirurgia , Neoplasias Cutâneas/patologia , Neoplasias das Glândulas Sudoríparas/cirurgia , Neoplasias das Glândulas Sudoríparas/patologia , Masculino , Idoso de 80 Anos ou maisAssuntos
Porocarcinoma Écrino , Neoplasias das Glândulas Sudoríparas , Humanos , Porocarcinoma Écrino/diagnóstico , Porocarcinoma Écrino/cirurgia , Porocarcinoma Écrino/patologia , Neoplasias das Glândulas Sudoríparas/diagnóstico , Neoplasias das Glândulas Sudoríparas/cirurgia , Neoplasias das Glândulas Sudoríparas/patologiaRESUMO
Eccrine porocarcinoma is a rare malignant tumor of the eccrine sweat gland. This malignancy occurs most commonly in the lower extremities. It tends to occur in patients aged 60 to 80 years, affecting men and women equally. We present the case of a 62-year-old man with a lesion on the left foot. The diagnosis of the initial biopsy was squamous cell carcinoma. Six months later, the lesion reoccurred, and a second biopsy confirmed it to be eccrine porocarcinoma.
Assuntos
Porocarcinoma Écrino , Neoplasias das Glândulas Sudoríparas , Humanos , Masculino , Pessoa de Meia-Idade , Biópsia , Glândulas Écrinas/patologia , Porocarcinoma Écrino/diagnóstico , Porocarcinoma Écrino/cirurgia , Porocarcinoma Écrino/patologia , Pé/patologia , Neoplasias das Glândulas Sudoríparas/diagnóstico , Neoplasias das Glândulas Sudoríparas/cirurgia , Neoplasias das Glândulas Sudoríparas/patologiaRESUMO
Eccrine porocarcinoma is a rare skin adnexal tumour that affects elderly people. Most eccrine porocarcinomas are stage I or II according to the American Joint Committee on Cancer. The prognosis is good in early stages, but worsens when advanced. Since information on the use of sentinel lymph node biopsy in these patients is scarce, this study examined the records of all patients with eccrine porocarcinoma treated at Helsinki University Hospital during a 17-year period and focused on sentinel lymph node biopsy patients. The study identified 14 patients (9 male, 5 female). There were 2 metastases to the lymph nodes and 2 recurrences at initial referral to our institution. All primary tumours had wide local excision and 6 patients also had sentinel lymph node biopsy, of whom none had positive lymph nodes. There were no new metastases or recurrences during follow-up. Three patients died of causes other than eccrine porocarcinoma. When comparing the wide local excision only and wide local excision with sentinel lymph node biopsy groups, no parameters reached statistical significance. The decision process of the multidisciplinary tumour board meeting on whether to perform sentinel lymph node biopsy was not clear, perhaps due to the limited knowledge of eccrine porocarcinoma. Further studies and international collaboration are warranted.
Assuntos
Porocarcinoma Écrino , Linfonodo Sentinela , Neoplasias das Glândulas Sudoríparas , Humanos , Masculino , Feminino , Idoso , Porocarcinoma Écrino/cirurgia , Porocarcinoma Écrino/patologia , Linfonodo Sentinela/patologia , Neoplasias das Glândulas Sudoríparas/cirurgia , Neoplasias das Glândulas Sudoríparas/patologia , Biópsia de Linfonodo Sentinela , Excisão de Linfonodo , Linfonodos/patologia , RecidivaRESUMO
Eccrine porocarcinoma is a rare and aggressive cutaneous malignancy that develops in the seventh and eight decades of life. We present a 76-year-old male with eccrine porocarcinoma developing from a long standing previously benign lesion who underwent successful treatment with wide local excision. It can also develop de novo, presenting most commonly as a mass or nodule. Tissue biopsy with histopathology is required to confirm the diagnosis. Wide local excision is recommended for local disease. Radiation and chemotherapy can be used as adjuncts in advanced and metastatic disease. Given its rarity, there are no guidelines to direct therapy for locally advance or metastatic disease and for follow-up. Further studies are needed to better understand and guide management of this entity.
Assuntos
Porocarcinoma Écrino , Segunda Neoplasia Primária , Neoplasias das Glândulas Sudoríparas , Masculino , Humanos , Idoso , Porocarcinoma Écrino/cirurgia , Porocarcinoma Écrino/diagnóstico , Porocarcinoma Écrino/patologia , Antebraço/cirurgia , Neoplasias das Glândulas Sudoríparas/cirurgia , Neoplasias das Glândulas Sudoríparas/diagnóstico , BiópsiaRESUMO
OBJECTIVE: Eccrine porocarcinoma (EPC) is a malignant adnexal tumor accounting for about 0.005% of skin tumors. The standard treatment of EPC is the complete surgical excision of the primary lesion and of the clinically involved lymph nodes. There is limited evidence regarding the role of radiotherapy (RT) in managing EPC after surgery. Therefore, the aim of this multidisciplinary systematic review is to analyze the available evidence about postoperative RT in the curative treatment of EPC. MATERIALS AND METHODS: A systematic search strategy was launched trough the main scientific databases including PubMed, Scopus and Cochrane. An additional manual search and a chain citation were performed about potentially relevant papers. The key words used for the search included "eccrine porocarcinoma", "porocarcinoma", "radiotherapy", "radiation therapy", "adjuvant radiotherapy" and "postoperative radiotherapy". RESULTS: A total of 104 publications were identified and 14 papers were included in the final analysis. The only articles found on adjuvant RT in EPC were case reports published between 1996 and 2019. There was a slight female prevalence (57% female/43% male) with a mean age of 65 years (range 37-85). Head-and-neck region was the most frequently involved anatomical site followed by legs. CONCLUSIONS: Adjuvant radiotherapy after surgical removal of EPC could be considered in cases with positive or close margins and in cases with unfavorable histological features. In view of limited literature data and the rarity of EPC the best treatment sequence should always be discussed within the frame of a multidisciplinary setting. ADVANCES IN KNOWLEDGE: adjuvant radiotherapy after surgical removal of EPC could be considered in cases with positive or close margins and in cases with unfavorable histological features.
Assuntos
Porocarcinoma Écrino , Neoplasias das Glândulas Sudoríparas , Adulto , Idoso , Idoso de 80 Anos ou mais , Porocarcinoma Écrino/patologia , Porocarcinoma Écrino/radioterapia , Porocarcinoma Écrino/cirurgia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Radioterapia Adjuvante , Neoplasias das Glândulas Sudoríparas/patologia , Neoplasias das Glândulas Sudoríparas/radioterapia , Neoplasias das Glândulas Sudoríparas/cirurgiaRESUMO
From the first report in 1969 to the present day, diagnosis of eccrine porocarcinoma, also known simply as porocarcinoma (PC), remains a challenge. This review presents a concise update of the history, pathogenesis, epidemiology, diagnosis, management and prognosis of this rare sweat gland neoplasm. PC differentiates towards the intraepidermal spiral ducts in the eccrine gland, is more common in people aged > 60 years and often affects the head, neck and legs. PC presents as a dome-shaped papule, plaque or nodule growing over weeks to months. The exact incidence of PC is unknown but appears to be rising. Diagnosis is difficult because of variable presentations and similar clinical and histological features to cutaneous squamous cell carcinoma. Management involves removal of the tumour, usually using wide local excision or Mohs micrographic surgery. Prognosis is poor, with PC recurring after surgery in 35% of cases. Given the lack of standardized protocols and risk profiles, further studies would help improve the understanding of PC.
Assuntos
Carcinoma de Células Escamosas , Porocarcinoma Écrino , Neoplasias Cutâneas , Neoplasias das Glândulas Sudoríparas , Porocarcinoma Écrino/diagnóstico , Porocarcinoma Écrino/epidemiologia , Porocarcinoma Écrino/cirurgia , Humanos , Recidiva Local de Neoplasia , Neoplasias das Glândulas Sudoríparas/diagnóstico , Neoplasias das Glândulas Sudoríparas/epidemiologia , Neoplasias das Glândulas Sudoríparas/cirurgiaRESUMO
ABSTRACT: Eccrine porocarcinoma (EPC) is a rare sweat gland malignancy. Recognition of histologic features is challenging, and specific pathologic features correlate with risk of poor outcome. This single-center retrospective review and case series of 58 EPC cases from 2000 to 2016 elucidates epidemiologic and pathologic characteristics of EPC. Pathology slides from 52 cases were analyzed by a dermatopathologist for standardized variable characteristics, including previously determined high-risk features (HRF) associated with poor prognosis. The incidence of EPC increased over the study period with 3 times more cases diagnosed in the last 4 years than in the first 4 years. Most cases were in the elderly males (mean age 75 years), and 50% were located in the head and neck region. Although 38% of tumors exhibited one histologic HRF, only 10% exhibited more than one. Of the HRF, a greater tumor depth was associated with both increased age (P = 0.04) and clear cell differentiation (P = 0.02). This study elucidates epidemiologic and pathologic features of EPC and highlights how age and clear cell differentiation can be associated with greater tumor depth, although further research is needed to determine whether clear cell differentiation is associated with poor clinical outcome.
Assuntos
Porocarcinoma Écrino/patologia , Neoplasias de Cabeça e Pescoço/patologia , Recidiva Local de Neoplasia/patologia , Neoplasias das Glândulas Sudoríparas/patologia , Fatores Etários , Idoso , Diferenciação Celular , Porocarcinoma Écrino/epidemiologia , Porocarcinoma Écrino/cirurgia , Extremidades , Feminino , Neoplasias de Cabeça e Pescoço/epidemiologia , Humanos , Incidência , Masculino , Invasividade Neoplásica , Prognóstico , Estudos Retrospectivos , Rhode Island/epidemiologia , Fatores de Risco , Neoplasias das Glândulas Sudoríparas/epidemiologia , Neoplasias das Glândulas Sudoríparas/cirurgia , TroncoRESUMO
Eccrine porocarcinoma is a rare malignant dermal appendageal tumor notorious for its varied morphology, both clinically and histologically; and it can pose a considerable diagnostic dilemma to both the dermatologist and the pathologist. Herein, we present a case of a 74-year-old woman with slow-growing nodular masses on both buttocks, reaching a fairly large size over a course of 3 years. Although atypical morphologic features posed significant diagnostic difficulty to both the surgeon and the pathologists, it was eventually diagnosed as eccrine porocarcinoma with focal squamoid features, using immunostains. To our knowledge, this is the second reported case of bilateral eccrine porocarcinoma which highlights the need for awareness of the morphological variations that this entity is capable of producing.
Assuntos
Porocarcinoma Écrino/diagnóstico , Neoplasias das Glândulas Sudoríparas/diagnóstico , Idoso , Carcinoma de Células Escamosas/diagnóstico , Diagnóstico Diferencial , Porocarcinoma Écrino/cirurgia , Feminino , Humanos , Imuno-Histoquímica , Melanoma/diagnóstico , Neoplasias das Glândulas Sudoríparas/cirurgiaAssuntos
Gerenciamento Clínico , Porocarcinoma Écrino/diagnóstico , Cirurgia de Mohs/métodos , Neoplasias das Glândulas Sudoríparas/diagnóstico , Idoso de 80 Anos ou mais , Progressão da Doença , Orelha Externa , Porocarcinoma Écrino/cirurgia , Feminino , Humanos , Neoplasias das Glândulas Sudoríparas/cirurgia , Tomografia Computadorizada por Raios XRESUMO
An 81-year-old woman presented with a progressively enlarging indurated, firm lesion encompassing one-third of the left upper eyelid. Four years prior, a similar lesion at that same site had been excised and diagnosed as a basal cell carcinoma. The patient underwent a full-thickness excision of the lesion with frozen section, cryotherapy, and reconstruction. A free tarsal graft and hard palate composite graft was used to reconstruct the posterior lamella. A Mustarde myocutaneous rotational flap was used to reconstruct the anterior lamella. Histopathology illustrated nests of pleomorphic basophilic cells with varying mitotic activity and immunohistochemical staining consistent with eccrine porocarcinoma. This case highlights similarities in the presentation and appearance of basal cell carcinoma and periorbital eccrine porocarcinoma. It is possible that there was de novo development of the 2 tumors on the eyelid or recurrence of a misdiagnosed eccrine porocarcinoma. Eccrine porocarcinomas are rare malignant sweat gland tumors associated with a risk of recurrence after excision and metastasis.
Assuntos
Carcinoma Basocelular , Porocarcinoma Écrino , Neoplasias Cutâneas , Neoplasias das Glândulas Sudoríparas , Idoso de 80 Anos ou mais , Carcinoma Basocelular/cirurgia , Porocarcinoma Écrino/diagnóstico , Porocarcinoma Écrino/cirurgia , Pálpebras , Feminino , Humanos , Recidiva Local de Neoplasia , Neoplasias das Glândulas Sudoríparas/diagnóstico , Neoplasias das Glândulas Sudoríparas/cirurgiaRESUMO
BACKGROUND Eccrine porocarcinoma (EPC) was first described in 1963 as an epidermotropic eccrine carcinoma. Fifty years later, its etiology remains poorly understood. The infrequent nature of this disease merits further inquiry into its etiology, presentation, and standards of management. Furthermore, the propensity for metastasis, which may be as high as 31% on presentation, increases the importance of investigating this rare disease. CASE REPORT The patient was a 63-year-old mechanic who presented with the lesion as a chronic wound following a chemical exposure. The lesion involved the ulnar aspect of his right palm and had concern for extension to the underlying tendons. He underwent a wide excision extending from the wrist to the proximal interphalangeal joint, preserving the ulnar neurovascular bundle. The hand was reconstructed with an anterolateral thigh fascia perforator flap and a skin graft. He had an excellent functional and cosmetic recovery. Unfortunately, he developed metastases to the lymph nodes, necessitating an axillary lymphadenectomy followed by adjuvant chemoradiation using concurrent cisplatin and docetaxel with radiation for 6 weeks. Follow-up at 18 months found no recurrence. CONCLUSIONS Cases of EPC presenting in the fingers have been managed with amputation of the involved phalanges; however, in addition to obtaining complete excision with negative margins, surgeons who deal with tumors of the hand must also consider the goals of limb preservation, functional preservation, and functional reconstruction. Options for reconstruction following excision include primary closure, dermal regeneration templates, skin grafts, flaps, and free-tissue transfer, depending on what tissue types are needed.
Assuntos
Porocarcinoma Écrino , Retalhos de Tecido Biológico , Procedimentos de Cirurgia Plástica , Neoplasias das Glândulas Sudoríparas , Porocarcinoma Écrino/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia , Neoplasias das Glândulas Sudoríparas/cirurgia , Resultado do TratamentoRESUMO
Skin cancer is the most common cancer within the United States. Reports estimate that 1 in 5 Americans will develop some form of skin cancer. Eccrine porocarcinoma is a rare type of skin cancer of sweat gland origin. Eccrine porocarcinoma is most commonly found on the lower extremities. Clinically it may appear similar to benign skin lesions and it has significant metastatic potential. The authors present a case report with 22 months' follow-up. It describes a multiyear delay in diagnosis involving 3 specialties, including primary care, dermatology, and wound physical therapy. Information is given on techniques when high-risk cutaneous cancers are suspected or encountered. A multispecialty treatment plan is discussed.Levels of Evidence: Level V.
Assuntos
Diagnóstico Tardio/prevenção & controle , Porocarcinoma Écrino/diagnóstico , Porocarcinoma Écrino/cirurgia , Hallux/cirurgia , Procedimentos Ortopédicos/métodos , Neoplasias das Glândulas Sudoríparas/diagnóstico , Neoplasias das Glândulas Sudoríparas/cirurgia , Idoso , Amputação Cirúrgica/métodos , Porocarcinoma Écrino/diagnóstico por imagem , Porocarcinoma Écrino/patologia , Humanos , Comunicação Interdisciplinar , Extremidade Inferior , Masculino , Equipe de Assistência ao Paciente , Doenças Raras , Biópsia de Linfonodo Sentinela , Tomografia Computadorizada com Tomografia Computadorizada de Emissão de Fóton Único , Neoplasias das Glândulas Sudoríparas/diagnóstico por imagem , Neoplasias das Glândulas Sudoríparas/patologia , Resultado do TratamentoRESUMO
BACKGROUND: The aim of the study is to analyze potential prognostic factors and to evaluate therapy strategies regarding clinical outcome in patients with eccrine porocarcinoma (EPC) of the head and neck. METHODS: One hundred and sixteen EPC cases from ninety studies and four authors' EPC cases were included in the meta-analysis. RESULTS: At an average follow up of 20.48 months, the 3-year overall survival and regional recurrence rate were 70.3% and 19.0%, respectively. Patients without surgical treatment had a significantly worse 3-year overall survival. Mohs microscopic surgery led to significantly less occurrence of regional recurrences compared to wide excision. An ulcerating lesion, high mitotic activity, and lymphovascular invasion were significant prognostic factors. CONCLUSION: Surgical resection is the cornerstone in the therapy of EPC and represents the therapeutic modality that offers the best chance of disease-free survival. Due to the high probability of recurrence, close follow-ups are strongly recommended.
Assuntos
Porocarcinoma Écrino , Neoplasias das Glândulas Sudoríparas , Porocarcinoma Écrino/cirurgia , Cabeça , Humanos , Cirurgia de Mohs , Recidiva Local de Neoplasia , Neoplasias das Glândulas Sudoríparas/cirurgiaRESUMO
The authors present a case of an eyelid eccrine porocarcinoma, a very rare malignant sweat gland tumor characterized histopathologically by nests of atypical poromatous cells and the presence of duct-like lumina. Histopathologic analysis of this case also exhibited numerous loose tumor cells in the adjacent tear film, a finding that has not been previously described.
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Porocarcinoma Écrino , Neoplasias Palpebrais , Neoplasias Cutâneas , Neoplasias das Glândulas Sudoríparas , Porocarcinoma Écrino/diagnóstico , Porocarcinoma Écrino/cirurgia , Pálpebras , Humanos , Neoplasias das Glândulas Sudoríparas/diagnóstico , Neoplasias das Glândulas Sudoríparas/cirurgiaAssuntos
Nádegas/patologia , Porocarcinoma Écrino/patologia , Ceratose Seborreica/diagnóstico , Pele/patologia , Neoplasias das Glândulas Sudoríparas/patologia , Idoso de 80 Anos ou mais , Porocarcinoma Écrino/diagnóstico , Porocarcinoma Écrino/etiologia , Porocarcinoma Écrino/cirurgia , Feminino , Humanos , Ceratose Seborreica/complicações , Ceratose Seborreica/patologia , Cirurgia de Mohs , Neoplasias das Glândulas Sudoríparas/diagnóstico , Neoplasias das Glândulas Sudoríparas/etiologia , Neoplasias das Glândulas Sudoríparas/cirurgiaRESUMO
Eccrine porocarcinoma (EPC) is an exceedingly rare sweat gland tumor most commonly seen in older patients. Diagnosis of EPC is rare, representing a small percentage of cutaneous malignancies. In the absence of established guidelines, wide local excision (WLE) has traditionally been considered the standard treatment. However, there is growing evidence of increased local recurrence and nodal metastasis associated with WLE. More recently, Mohs micrographic surgery (MMS) is emerging as an effective treatment method with higher cure rates. We report a case of EPC presenting as a recurrent wart in a 36-year-old man that was successfully treated with MMS.