Eccrine porocarcinoma with extensive cutaneous metastases

Area of Science:

• Dermatology
• Oncology
• Pathology

Background:

• Eccrine porocarcinoma (EPC) is a rare malignant neoplasm arising from the intraepidermal eccrine sweat duct.
• While typically slow-growing, EPC has a metastatic potential to regional lymph nodes in up to 20% of cases, increasing mortality.

Observation:

• Three cases of extensive metastatic EPC in elderly women (89-96 years) with multiple left leg tumors are presented.
• One patient had a history of excised primary EPC 6 years prior; two had prior lesions diagnosed as squamous cell carcinoma.

Findings:

• Histopathological and immunohistochemical analyses confirmed metastatic EPC in all three patients.
• Treatment involved palliative radiotherapy and/or chemotherapy, with only one patient surviving.
• A notable finding was a long latency period before metastasis in one case.

Implications:

• Metastatic EPC in the elderly, especially with extensive leg involvement, poses diagnostic and therapeutic challenges.
• Delayed diagnosis of primary EPC can hinder timely, aggressive treatment.
• Even with optimal treatment, prognosis for metastatic EPC remains guarded.