Sebaceous differentiation in poroid neoplasms: report of 11 cases,
including a case of metaplastic carcinoma associated with apocrine
poroma (sarcomatoid apocrine porocarcinoma).
We describe 11
poroid neoplasms with sebaceous differentiation, including a
metaplastic (sarcomatoid) carcinoma arising in association with an
apocrine poroma. Six lesions had the silhouette of a classical poroma,
3 of poroid hidradenoma and 1 of dermal duct tumor. In all cases,
sebaceous differentiation was identified as clustered or solitary,
mature sebocytes occurring mainly at the periphery of intradermal
cellular aggregations, accompanied by sebaceous ducts. In one poroma,
clusters of sebocytes were seen within intradermal aggregates and
intraepidermally. In 1 of the 3 poroid hidradenomas, the eosinophilic
cuticle lining the cyst was crenulated in foci associated with
sebocytes. In none of the cases were there signs of follicular
differentiation. One poroma, in addition to sebaceous differentiation,
showed decapitation secretion in some ductular structures. The single
carcinoma was an ulcerated oval to spindle cell neoplasm surrounded
laterally by the residuum of a poroma containing groups of sebocytes.
The epithelial islands of the poroma were prominently keratinized and
blended gradually with the pleomorphic cells of the metaplastic
carcinoma that immunohistochemically stained focally for cytokeratins
and simultaneously showed strong vimentin expression. Our study
supports previous findings that sebaceous differentiation can be
identified not only in classical poroma but also in the related
lesions known as dermal duct tumor and poroid hidradenoma. Occurrence
of metaplastic carcinoma in association with apocrine poroma is a rare
event which indicates the existence of a malignant counterpart of the
latter entity, which can be descriptively referred to as "sarcomatoid
apocrine porocarcinoma."
Pigmented eccrine poromas:
expression of melanocyte-stimulating cytokines by tumour cells does
not always result in melanocyte colonization.J
Eur Acad Dermatol Venereol. 2008 Mar; 22(3): 303-10.
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.