Difference between revisions of "Porocarcinoma"

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{{ Infobox diagnosis
| Name      = {{PAGENAME}}
| Image      = Porocarcinoma - alt -- low mag.jpg
| Width      =
| Caption    = Porocarcinoma. [[H&E stain]].
| Synonyms  =
| Micro      =
| Subtypes  =
| LMDDx      = [[basal cell carcinoma]], [[squamous cell carcinoma of the skin|squamous cell carcinoma]], [[pyogenic granuloma]], [[verruca vulgaris]],
[[adenocarcinoma]], [[malignant melanoma]]
| Stains    =
| IHC        = [[CD117]] +ve
| EM        =
| Molecular  =
| IF        =
| Gross      =
| Grossing  =
| Staging    =
| Site      = skin - typically head & neck
| Assdx      =
| Syndromes  =
| Clinicalhx =
| Signs      =
| Symptoms  =
| Prevalence = very rare
| Bloodwork  =
| Rads      =
| Endoscopy  =
| Prognosis  = poor
| Other      =
| ClinDDx    =
| Tx        = surgical excision
}}
'''Porocarcinoma''' is a rare [[malignant]] [[skin tumour]] that has an aggressive behaviour.<ref name=pmid28721214>{{Cite journal  | last1 = Salih | first1 = AM. | last2 = Kakamad | first2 = FH. | last3 = Baba | first3 = HO. | last4 = Salih | first4 = RQ. | last5 = Hawbash | first5 = MR. | last6 = Mohammed | first6 = SH. | last7 = Othman | first7 = S. | last8 = Saeed | first8 = YA. | last9 = Habibullah | first9 = IJ. | title = Porocarcinoma; presentation and management, a meta-analysis of 453 cases. | journal = Ann Med Surg (Lond) | volume = 20 | issue =  | pages = 74-79 | month = Aug | year = 2017 | doi = 10.1016/j.amsu.2017.06.027 | PMID = 28721214 }}</ref>
'''Porocarcinoma''' is a rare [[malignant]] [[skin tumour]] that has an aggressive behaviour.<ref name=pmid28721214>{{Cite journal  | last1 = Salih | first1 = AM. | last2 = Kakamad | first2 = FH. | last3 = Baba | first3 = HO. | last4 = Salih | first4 = RQ. | last5 = Hawbash | first5 = MR. | last6 = Mohammed | first6 = SH. | last7 = Othman | first7 = S. | last8 = Saeed | first8 = YA. | last9 = Habibullah | first9 = IJ. | title = Porocarcinoma; presentation and management, a meta-analysis of 453 cases. | journal = Ann Med Surg (Lond) | volume = 20 | issue =  | pages = 74-79 | month = Aug | year = 2017 | doi = 10.1016/j.amsu.2017.06.027 | PMID = 28721214 }}</ref>
It is also known as '''eccrine porocarcinoma''' (abbreviated '''EPC''') and '''malignant eccrine poroma'''.<ref name=pmid20668633>{{Cite journal  | last1 = Luz | first1 = Mde A. | last2 = Ogata | first2 = DC. | last3 = Montenegro | first3 = MF. | last4 = Biasi | first4 = LJ. | last5 = Ribeiro | first5 = LC. | title = Eccrine porocarcinoma (malignant eccrine poroma): a series of eight challenging cases. | journal = Clinics (Sao Paulo) | volume = 65 | issue = 7 | pages = 739-42 | month = Jul | year = 2010 | doi = 10.1590/S1807-59322010000700014 | PMID = 20668633 }}</ref>


==General==
==General==
*Malignant counterpart of ''[[poroma]]''.
*Malignant counterpart of ''[[poroma]]''.<ref name=pmid28954110 >{{Cite journal  | last1 = Abarzúa | first1 = Á. | last2 = Álvarez-Véliz | first2 = S. | last3 = Moll-Manzur | first3 = C. | title = Concomitant poroma and porocarcinoma. | journal = An Bras Dermatol | volume = 92 | issue = 4 | pages = 550-552 | month =  | year =  | doi = 10.1590/abd1806-4841.20175719 | PMID = 28954110 }}</ref>
*Very rare ~ most papers are case reports.<ref name=pmid25515648>{{Cite journal  | last1 = Riera-Leal | first1 = L. | last2 = Guevara-Gutiérrez | first2 = E. | last3 = Barrientos-García | first3 = JG. | last4 = Madrigal-Kasem | first4 = R. | last5 = Briseño-Rodríguez | first5 = G. | last6 = Tlacuilo-Parra | first6 = A. | title = Eccrine porocarcinoma: epidemiologic and histopathologic characteristics. | journal = Int J Dermatol | volume = 54 | issue = 5 | pages = 580-6 | month =  | year = 2015 | doi = 10.1111/ijd.12714 | PMID = 25515648 }}</ref>


Clinical - based on meta-analysis of 453 cases:
Clinical features - based on meta-analysis of 453 cases:<ref name=pmid28721214/>
*No predominance males versus females.
*No predominance males versus females.
*Aggressive behaviour >30% of cases have metastases at presentation - typically to lymph nodes.
Treatment:
*Surgery,


==Gross==
==Gross==
*Mass or nodule - typically head and neck (40% of cases) or lower extremity (34% of cases).<ref name=pmid28721214/>
*Mass or nodule - typically head and neck (40% of cases) or lower extremity (34% of cases).<ref name=pmid28721214/>


==Microscopic==
Features:
*Ductal/eccrine differentiation:<ref name=pmid20668633/>
**Intracytoplasmic lumens.
**Multicellular ducts with thin esoinophilic layer.
**Lack granular cells and lack decapitated lumens - features of apocrine differentiation.
*Features of malignancy:<ref name=pmid20668633/>
**[[Desmoplastic stromal response]].
**Irregular dermis infiltrating cell clusters.
*+/-Squamous differentiation.
*+/-Basaloid differentiation.
DDx:<ref name=pmid28954110/>
*[[Basal cell carcinoma]].
*[[Squamous cell carcinoma of the skin|Squamous cell carcinoma]].
*[[Pyogenic granuloma]].
*[[Verruca vulgaris]].
*[[Adenocarcinoma]].
*[[Malignant melanoma]] - desmoplastic and nodular variants.
===Images===
<gallery>
Image: Porocarcinoma -- very low mag.jpg | Porocarcinoma - very low mag.
Image: Porocarcinoma -- low mag.jpg | Porocarcinoma - low mag.
Image: Porocarcinoma -- intermed mag.jpg | Porocarcinoma - intermed. mag.
Image: Porocarcinoma - alt -- intermed mag.jpg | Porocarcinoma - intermed. mag.
Image: Porocarcinoma -- high mag.jpg | Porocarcinoma - high mag.
Image: Porocarcinoma -- very high mag.jpg | Porocarcinoma - very high mag.
</gallery>
====www====
*[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5595608/figure/f4/?report=objectonly Eccrine porocarcinoma (nih.gov)].<ref name=pmid28954110/>
*[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3884174/figure/F2/ Porocarcinoma (nih.gov)].<ref name=pmid24403888>{{Cite journal  | last1 = Kurashige | first1 = Y. | last2 = Minemura | first2 = T. | last3 = Nagatani | first3 = T. | title = Eccrine porocarcinoma: clinical and pathological report of eight cases. | journal = Case Rep Dermatol | volume = 5 | issue = 3 | pages = 259-66 | month =  | year = 2013 | doi = 10.1159/000355606 | PMID = 24403888 }}</ref>


==IHC==
Features:<ref>{{Cite journal  | last1 = Goto | first1 = K. | last2 = Takai | first2 = T. | last3 = Fukumoto | first3 = T. | last4 = Anan | first4 = T. | last5 = Kimura | first5 = T. | last6 = Ansai | first6 = S. | last7 = Oshitani | first7 = Y. | last8 = Murata | first8 = Y. | last9 = Sakuma | first9 = T. | title = CD117 (KIT) is a useful immunohistochemical marker for differentiating porocarcinoma from squamous cell carcinoma. | journal = J Cutan Pathol | volume = 43 | issue = 3 | pages = 219-26 | month = Mar | year = 2016 | doi = 10.1111/cup.12632 | PMID = 26449497 }}</ref>
*[[CD117]] +ve (~100% of porocarcinoma, ~20% of [[squamous carcinoma]]s focally).


==See also==
==See also==
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[[Category:Diagnosis]]
[[Category:Diagnosis]]
[[Category:Dermatopathology]]

Latest revision as of 19:24, 8 February 2019

Porocarcinoma
Diagnosis in short

Porocarcinoma. H&E stain.
LM DDx

basal cell carcinoma, squamous cell carcinoma, pyogenic granuloma, verruca vulgaris,

adenocarcinoma, malignant melanoma
IHC CD117 +ve
Site skin - typically head & neck
Prevalence very rare
Prognosis poor
Treatment surgical excision

Porocarcinoma is a rare malignant skin tumour that has an aggressive behaviour.[1]

It is also known as eccrine porocarcinoma (abbreviated EPC) and malignant eccrine poroma.[2]

General

  • Malignant counterpart of poroma.[3]
  • Very rare ~ most papers are case reports.[4]

Clinical features - based on meta-analysis of 453 cases:[1]

  • No predominance males versus females.
  • Aggressive behaviour >30% of cases have metastases at presentation - typically to lymph nodes.

Treatment:

  • Surgery,

Gross

  • Mass or nodule - typically head and neck (40% of cases) or lower extremity (34% of cases).[1]

Microscopic

Features:

  • Ductal/eccrine differentiation:[2]
    • Intracytoplasmic lumens.
    • Multicellular ducts with thin esoinophilic layer.
    • Lack granular cells and lack decapitated lumens - features of apocrine differentiation.
  • Features of malignancy:[2]
  • +/-Squamous differentiation.
  • +/-Basaloid differentiation.

DDx:[3]

Images

  • Porocarcinoma - very low mag.

  • Porocarcinoma - low mag.

  • Porocarcinoma - intermed. mag.

  • Porocarcinoma - intermed. mag.

  • Porocarcinoma - high mag.

  • Porocarcinoma - very high mag.

www

IHC

Features:[6]

See also

References

  1. ↑ 1.0 1.1 1.2 Salih, AM.; Kakamad, FH.; Baba, HO.; Salih, RQ.; Hawbash, MR.; Mohammed, SH.; Othman, S.; Saeed, YA. et al. (Aug 2017). "Porocarcinoma; presentation and management, a meta-analysis of 453 cases.". Ann Med Surg (Lond) 20: 74-79. doi:10.1016/j.amsu.2017.06.027. PMID 28721214.
  2. ↑ 2.0 2.1 2.2 Luz, Mde A.; Ogata, DC.; Montenegro, MF.; Biasi, LJ.; Ribeiro, LC. (Jul 2010). "Eccrine porocarcinoma (malignant eccrine poroma): a series of eight challenging cases.". Clinics (Sao Paulo) 65 (7): 739-42. doi:10.1590/S1807-59322010000700014. PMID 20668633.
  3. ↑ 3.0 3.1 3.2 Abarzúa, Á.; Álvarez-Véliz, S.; Moll-Manzur, C.. "Concomitant poroma and porocarcinoma.". An Bras Dermatol 92 (4): 550-552. doi:10.1590/abd1806-4841.20175719. PMID 28954110.
  4. ↑ Riera-Leal, L.; Guevara-Gutiérrez, E.; Barrientos-García, JG.; Madrigal-Kasem, R.; Briseño-Rodríguez, G.; Tlacuilo-Parra, A. (2015). "Eccrine porocarcinoma: epidemiologic and histopathologic characteristics.". Int J Dermatol 54 (5): 580-6. doi:10.1111/ijd.12714. PMID 25515648.
  5. ↑ Kurashige, Y.; Minemura, T.; Nagatani, T. (2013). "Eccrine porocarcinoma: clinical and pathological report of eight cases.". Case Rep Dermatol 5 (3): 259-66. doi:10.1159/000355606. PMID 24403888.
  6. ↑ Goto, K.; Takai, T.; Fukumoto, T.; Anan, T.; Kimura, T.; Ansai, S.; Oshitani, Y.; Murata, Y. et al. (Mar 2016). "CD117 (KIT) is a useful immunohistochemical marker for differentiating porocarcinoma from squamous cell carcinoma.". J Cutan Pathol 43 (3): 219-26. doi:10.1111/cup.12632. PMID 26449497.
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