Eccrine porocarcinoma

1. MAPCON 2017
Slide Seminar – Case no. 115
Department of Pathology
ACPM Medical College,
Dhule

2. History
• 65 years male patient presented with non
healing ulcer on anterolateral aspect of right
thigh since 6 months.
• Gradual increase in size was noted. Wide
local surgical excision done.
• Mass measuring 3 cm in diameter & surgical
resection of 16x6x2 cm. received.

3. Ulceroproliferative mass of 3 cm in diameter.
In a surgical resection of 16x6x2 cm.

4. C/S - Mass 3 x 3 x 0.5 cm whitish in colour with
cystic lumina seen in the tumour

5. Infiltration seen upto subcutaneous fat

6. Atypical poroid cells infiltrating into dermis as
anastomosing bands and dermal tumor islands

7. Dermal tumour islands

8. Eccrine differentiation was indicated by
spiraling ductular structures

9. Cells reveal- Pleomorphism, hyperchromatic nuclei
with prominent nucleoli & moderate cytoplasm.

10. Nuclear pleomorphism, Mitotic index >14

11. Immunohistochemistry
CK 15
CK 7

13. Immunohistochemistry
EMA Estrogen

14. Immunohistochemistry
• The tumour was positive for
• EMA,
• CK7, CK15,
• Estrogen receptor
• Immuno-negative for
CK20, D240, CEA, BerFP4, CD10, GCDFP-15.
• CK20(), D240(), CEA(), BerFP4(), CD10(), GCDFP-
15().

15. Final Diagnosis
ECCRINE POROCARCINOMA

16. Discussion
• Eccrine porocarcinoma (EPC) represents 0.005%
of all malignant epithelial neoplasms.
• Majority patients older, peak incidence 67 yrs.
• M=F, a slight predominance in women.
• 20% of EPC recur after excision,
• 20% have nodal metastasis,
• 12% develop distant metastasis.
• Patients with metastasis have a high mortality
rate

17. Histogenesis
• Forms in the intraepidermic ductal portion of
the sweat gland.
• Etiology remains unknown (EPC arises from
malignant transformation of Eccrine
Poroma).
• Diagnosis of EPC requires clinical,
histopathological and IHC characterization.

18. Prognosis
• Histological findings that predict the worse
prognosis are
- lymphovascular invasion,
- mitotic index of >14 mitotic cells/hpf
- tumoral depth of more than 7 mm.
• No standard therapeutic protocol for EPC.
• Wide excision with clear margins (HPE)
is treatment of choice.
• Infiltrative tumour margin has influence on local
recurrence.

19. References
1. Murilo de Almeida Luz,I Daniel Cury Ogata,II Marcos Flávio Gomes Montenegro
eccrine porocarcinoma (malignant eccrine poroma): a series of eight challenging
cases CLINICS 2010;65(7):739-42
2. Ugo Marone, Corrado Caracò, Anna Maria Anniciello, Gianluca Di Monta
Metastatic eccrine porocarcinoma: report of a case and review of the literature
Marone et al. World Journal of Surgical Oncology 2011, 9:32
3. Harish S. Permi & Shubha P. Bhat Kishan Prasad H. L. Eccrine Porocarcinoma of
Scalp: An Uncommon Tumor at an Unusual Site Indian J Surg Oncol (April–June
2011) 2(2):145–147