Malignant sweat gland tumour

  

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Pathology of Eccrine

Porocarcinoma

Dr Sampurna Roy MD

Dermatopathology Quiz Case 180

Dermatopathology Quiz Case 4

Diagnosis: Porocarcinoma

Dermpath- India

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 Dr Sampurna Roy MD

       

http://www.histopathology-india.net/dermpath.htm

December  2014

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Benign sweat gland tumours

Cysts:

Hydrocystoma -Eccrine/Apocrine

Hamartomas:

Eccrine/Apocrine naevus

Eccrine  Angiomatous Hamartoma

Porokeratotic  eccrine ostial naevus

Benign Neoplasms:

Syringo cystadenoma Papilliferum

Hidradenoma Papilliferum

Nipple Adenoma

Syringoma

Spiradenoma

Cylindroma

Chondroid Syringoma (benign mixed tumour)

Poroma

Hidradenoma

Apocrine adenoma

Papillary eccrine adenoma

Syringo fibroadenoma

Malignant sweat gland tumour 

Low grade:

Microcystic   adnexal carcinoma

Eccrine   epithelioma

Adenoid cystic carcinoma

Mucinous  carcinoma

Primary extramammary Paget’s disease

Intermediate grade:

Porocarcinoma

Digital papillary adenocarcinoma

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

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

A rare case of abdominal porocarcinoma.

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

Eccrine porocarcinoma: clinical and pathological report of eight cases.

Eccrine porocarcinoma: a case report.

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

Successful management of metastatic eccrine porocarcinoma.

[Eccrine Porocarcinoma: clinical-pathological study of 19 cases in the Instituto Nacional de Enfermedades Neoplásicas, Lima - Peru].

Metastatic eccrine porocarcinoma.

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.

FDG PET/CT in Malignant Eccrine Porocarcinoma Arising in a Pre-existing Poroma.

[Eccrine porocarcinoma of the scalp].

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

Fine-needle aspiration findings of metastatic porocarcinoma.

An immunohistochemical comparison of cytokeratin 7, cytokeratin 15, cytokeratin 19, CAM 5.2, carcinoembryonic antigen, and nestin in differentiating porocarcinoma from squamous cell carcinoma.

Porocarcinoma: case report.

Porocarcinoma Arising in Pigmented Hidroacanthoma Simplex.

Unusual case of porocarcinoma of the foot with no clinically evident dermatologic manifestations.

Porocarcinoma in a patient with chronic arsenism and multiple Bowen's disease: case report.

Eccrine porocarcinoma of the upper eyelid.

Malignant eccrine poroma.

Eccrine porocarcinoma (malignant eccrine poroma): a case report.  

Eccrine porocarcinoma with Bowenoid changes: epithelial membrane antigen is not a useful marker for malignant tumours arising from eccrine gland structures.

Widespread metastatic eccrine porocarcinoma.

Eccrine sweat gland carcinoma of the skin.

Eccrine porocarcinoma with extensive cutaneous metastasis.  

Aberrant expression of p16 and RB protein in eccrine porocarcinoma.

Malignant eccrine poroma in an unusual location.

Unusual metastatic spread of a malignant eccrine poroma.  

Malignant eccrine poroma in an elderly African-American woman

Malignant eccrine poroma with multiple visceral metastasis: report of a case with autopsy findings.  

Porocarcinoma of the heel. A case report with unusual histologic features.

Metastasizing eccrine porocarcinoma: report of a case and review of the literature.

Clear cell eccrine carcinomas of the skin. A clinicopathologic study of nine patients.

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

Adnexal carcinomas of skin. Cancer.  

Eccrine adenocarcinoma. A clinicopathologic study of 35 cases.  

Eccrine porocarcinoma: a case report with light microscopy and ultrastructure.  

Carcinomas of Sweat Glands

Dr Sampurna Roy  MD

Consultant  Histopathologist (Kolkata - India)

 

Histology of the Normal Skin

Glossary 

Gross examination of  the skin specimen

Reporting of biopsies taken for Inflammatory Skin Diseases

Lichenoid (Interface)Tissue Reaction Pattern

Psoriasiform Reaction Pattern

Vesiculobullous Reaction Pattern

Spongiotic Reaction Pattern

Vascular Diseases: Various forms of Vasculitis

Lichen planus-like  lesions

Lichen Nitidus

Bullous Pemphigoid

Dermatitis Herpetiformis

Hailey-Hailey Disease 

Granulomatous Reaction Pattern of the Skin

Granuloma Annulare

Necrobiosis Lipoidica

Necrobiotic Xanthogranuloma   

Rheumatoid Nodule

Lupus Vulgaris

Cutaneous Sarcoidosis

Melkersson Rosenthal Syndrome

Annular Elastolytic Giant Cell Granuloma

Skin lesion in Crohn's Disease

Blastomycosis-like pyoderma

Foreign body granuloma

Rosacea

Interstitial Granulomatous Dermatitis

Interstitial Granulomatous Drug Reaction

Erythema Nodosum

Folliculitis

Impetigo

Furuncle(Boil)

Carbuncle

Toxic Shock Syndrome

Allergic Granulomatosis (Churg-Strauss Syndrome)

Median Raphe Cyst

Cutaneous Ciliated Cyst

Infective Panniculitis

Pancreatic Panniculitis

Drug related cutaneous lesions

Cutaneous lesion in graft-
versus host disease

Cutaneous lesions after exposure to Radiation

 

High grade:

Hidradeno carcinoma

Apocrine adenocarcinoma

Eccrine ductal carcinoma

Spiradeno carcinoma

Malignant cylindroma

Sebaceous tumours

Fordyce's Spots

Steatocystoma

Nevus Sebaceous

Folliculosebaceous Cystic Hamartoma

Sebaceous Hyperplasia

Sebaceoma

Sebaceous Adenoma

Sebaceous Carcinoma


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