Eccrine Carcinoma

  • Eccrine carcinoma is an extremely rare neoplasm of the skin:
    • That accounts for approximately 0.005% of malignant epithelial neoplasia
  • It arises from the eccrine sweat glands:
    • There are least 10 described subtypes
  • Due to the rarity of these neoplasms:
    • Exact etiology and clinical recommendations are not clear
  • Most of these tumors are:
    • Slow-growing, solitary, dermal nodules:
      • That often arise from pre-existing benign skin lesions
  • Most common distribution is seen in:
    • The head, neck, and extremities
  • The diagnosis is often delayed:
    • Because of its relative rarity as well as difficulty in identification with traditional light microscopy
  • Recurrence is common
  • A wide local excision is the recommended treatment of choice:
    • With a 70% to 80% cure rate
  • Mohs microsurgery:
    • Can be used on cosmetically sensitive areas
  • Predictive factors for recurrence include:
    • Tumors thicker than 7 mm
    • Lymphovascular invasion
    • Greater than 14 mitoses per high power field
    • Dermal infiltration
  • Performing SLN biopsy on these patients is controversial:
    • Lymph node metastasis is relatively rare and sentinel lymph node biopsy:
      • Is not routinely performed for all cases
  • Distant metastases are rare and cross-sectional imaging for staging work-up should be performed only when clinically indicated
  • Recurrent tumors:
    • Are high risk for locoregional failure:
      • Should be considered for a sentinel lymph node biopsy
  • Distant metastasis is rare and any additional staging scans are not recommended
  • Radiation and chemotherapy have not demonstrated any significant benefit in the adjuvant setting
  • References
    • Barnes M, Hestley A, Murray DR, Carlson GW, Parker D, Delman KA. The risk of lymph node involvement in malignant cutaneous adnexal tumors. Am Surg. 2014;80:270-274.
    • Kampshoff JL, Cogbill TH. Unusual skin tumors: Merkel cell carcinoma, eccrine carcinoma, glomus tumors, and dermatofibrosarcoma protuberans. Surg Clin North Am. 2009;89:727-738.
    • Luz Mde A, Ogata DC, Montenegro MF, Biasi LJ, Ribeiro LC. Eccrine porocarcinoma (malignant eccrine poroma): A series of eight challenging cases. Clinics (Sao Paulo). 2010;65:739-742.
    • Wick MR, Goellner JR, Wolfe JT III, Su WP. Adnexal carcinomas of the skin, II: extraocular sebaceous carcinomas. Cancer. 1985;56:1163-1172.

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