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Mohs micrographic surgery for squamoid eccrine ductal carcinoma
Yong Ju Kim1, Ae Ree Kim, Dong Soo Yu
1Department of Dermatology, Korea University Guro Hospital, Seoul, Korea.
Summary
Squamoid eccrine ductal carcinoma, a rare skin cancer, was successfully treated with Mohs micrographic surgery. This technique achieved complete tumor removal with clear margins, indicating its efficacy for eccrine carcinomas.
Area of Science:
- Dermatology
- Surgical Oncology
- Pathology
Background:
- Squamoid eccrine ductal carcinoma (SEDC) is a rare skin malignancy with undefined surgical margin standards.
- SEDC can clinically mimic squamous cell carcinoma, complicating diagnosis and treatment.
- Established treatment protocols for eccrine carcinomas are lacking.
Observation:
- A case of SEDC presenting as a neck nodule in a 30-year-old Korean woman was diagnosed.
- Initial diagnosis via punch biopsy suggested squamous cell carcinoma.
- The tumor exhibited both eccrine and squamous differentiation upon histopathologic examination.
Findings:
- Mohs micrographic surgery achieved complete removal of the 2.3 x 2.5 cm wide, 1.5 cm deep tumor.
- The squamous component expressed epithelial membrane antigen and cytokeratin 5/6.
- The ductal component expressed anti-carcinoembryonic antigen.
- The patient remained disease-free 14 months post-surgery, despite the aggressive nature of eccrine carcinomas.
Implications:
- SEDC should be included in the differential diagnosis for cutaneous neoplasms with squamoid and ductal features.
- Mohs micrographic surgery is a viable and effective surgical option for complete excision of SEDC.
- This case highlights the potential of Mohs surgery for managing rare eccrine ductal carcinomas.