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Pathology of Eccrine

Porocarcinoma

Dr Sampurna Roy MD     

 

Eccrine porocarcinoma was first described by Pinkus and Mehregan as 'epidermotropic eccrine carcinoma' and probably represents the commonest form of sweat gland carcinoma.

The name was coined by Mishima and Morioka in 1969.

Oncogenic differentiation of the intraepidermal eccrine sweat duct: eccrine poroma, poroepithelioma and porocarcinoma.

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Some tumours are of long duration suggesting malignant transformation of a poroma or hidroacanthoma simplex.

Rarely some may arise from organoid nevus.

Age:  Predilection for older patients  

Site: Usually located on distal extremities.

Clinical presentation: Presents as a verrucous plaque or polypoid growth.

Microscopic features:

- Asymmetrical ; Infiltrative growth pattern  ; 

- Large smooth islands and small irregular shaped nests ; 

- Focal necrosis (comedonecrosis) ;  

- 2 types of atypical cells: eosinophilic and clear cells.

Eosinophilic cells-

Polyhedral or fusiform with round to oval hyperchromatic nuclei, distinct nucleoli, indistinct cell boundaries, and a variable amount of cytoplasm (small eosinophilic cells or large eosinophilic cells); 

Clear cells-

Large and polyhedral with round to oval nuclei, abundant clear cytoplasm, and distinct cell borders; Clear cell areas are less prominent than hidradenocarcinoma  ;

- Ductal structures  ;  Intracytoplasmic lumina formation ;

- Squamous differentiation ; Melanin pigment is demonstrated in some cases ;

- Tumour shows multiple attachments to the epidermis ;

- Inflammatory infiltrate around neoplastic masses is composed of lymphocytes and plasma cells, rarely mixed with neutrophils and  eosinophils ;

- Tumour with only intra-epidermal component is known as in-situ porocarcinoma ;

- Intraepidermal portion of the growth is composed of large atypical cells arranged in irregular nests and islands, variable in size and in shape, and sharply demarcated from the surrounding epidermal keratinocytes.

Benign component of poroma and hidroacanthoma simplex is present in about 10% of cases.

Neoplastic cells contain glycogen and intratubular, PAS-positive, diastase-resistant material is usually present.

Immunocytochemistry:  Tumour is cytokeratin , CEA and epithelial membrane antigen positive.

Local recurrence rate is lower than some low grade tumour.

Metastasis to local lymphnode may be present in 10-20% of cases.

Multiple cutaneous deposits and microscopic epidermotropic deposits may develop.

 

Further reading

Eccrine porocarcinoma: a report of 2 cases and review of the literature.

Eccrine porocarcinoma: clinical and pathological report of eight cases.

Pigmented porocarcinoma: a case report with review of the literature.

Eccrine porocarcinoma: cytologic diagnosis by fine needle aspiration biopsy (FNAB).

A case of eccrine porocarcinoma: usefulness of immunostain for s-100 protein in the diagnoses of recurrent and metastatic dedifferentiated lesions.

Eccrine porocarcinoma of the scalp.

Porocarcinoma on the face: a rare location. Review of the literature to explore its biological behavior.

Eccrine porocarcinoma. A review of 24 cases.

Carcinoma of Sweat glands.  Pathol Annual. 1987: 22 (part1): 83-124.

Sweat gland carcinoma: A comprehensive review.  Semin Diagn Pathol. 1987 Feb; 4(1) : 38-74

 

 

 

 

Dr Sampurna Roy  MD

Consultant  Histopathologist (Kolkata - India)

                                                                                                                                                    


 

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