Eccrine adenocarcinoma--report of a case, treatment with Mohs surgery

Eccrine adenocarcinomas are neoplasms with a low incidence of occurrence and a prolonged and insidious course. The diversity of the histologic findings compatible with the diagnosis contributes to the difficulty of establishing a histologic prognosis from the pathology. Tumors with histologic features consistent with benign adenomas have subsequently metastasized, reflecting both the variable behavior of these tumors and problems with diagnostic and prognostic classification. Eccrine adenocarcinoma usually presents as a discrete lesion involving the scalp or upper extremities. It may also occur on the trunk and lower extremities. The gross morphology of the tumor is not specific, therefore the clinical diagnosis of eccrine adenocarcinoma is rarely made. Herein we report a case of the malignant eccrine acrospiroma type with lymph node metastasis, an approach to therapy, and guidelines for histologic criteria of malignancy.