10.5826/dpc.1203a135
text/xml
2160-9381
2097
en
Thaís Corsetti Grazziotin
https://creativecommons.org/licenses/by-nc/4.0
Dermatology Practical & Conceptual
tumor
Eccrine porocarcinoma arising from an eccrine poroma: case report
Text.Serial.Journal
https://dpcj.org/index.php/dpc
Research Letter
2022-07-28
2021-10-12
2022-07-28
2022-09-15
e2022135
Dermatol Pract Concept
Thaís Corsetti Grazziotin
2022/07/28
10.5826/dpc.1203a135
e2022135
Department of Dermatology, Hospital São Lucas, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS)
2160-9381
tumor
en
e2022135
Eccrine porocarcinoma arising from an eccrine poroma: case report
https://dpcj.org/index.php/dpc/article/download/2097/1702
                    Dermatology Practical & Conceptual


       Eccrine Porocarcinoma Arising From an Eccrine
                   Poroma: a Case Report
            Ingrid Silveira1, Gabriela Siliprandi Lorentz Sartori1, André da Silva Cartell1,2,
                                       Thaís Corsetti Grazziotin1


1 Department of Dermatology, Hospital São Lucas, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS)
2 Department of Pathology, Universidade Federal do Rio Grande do Sul (UFRGS) Porto Alegre, Brazil



Keywords: eccrine porocarcinoma, eccrine poroma, dermoscopy, sweat gland, tumor
Citation: Silveira I, Siliprandi Lorentz Sartori G, da Silva Cartell A, Corsetti Grazziotin T. Eccrine porocarcinoma arising from an eccrine
poroma: case report. Dermatol Pract Concept. 2022;12(3):e2022135. DOI: https://doi.org/10.5826/dpc.1203a135
Accepted: December 21, 2021; Published: July 2022
Copyright: ©2022 Silveira et al. This is an open-access article distributed under the terms of the Creative Commons Attribution
License (BY-NC-4.0), https://creativecommons.org/licenses/by-nc/4.0/ which permits unrestricted noncommercial use, distribution, and
reproduction in any medium, provided the original authors and source are credited.
Funding: None.
Competing interests: None.
Authorship: All authors have contributed significantly to this publication.
Corresponding author: Thais Corsetti Grazziotin, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS). Email thais.grazziotin@
pucrs.br



Introduction                                                             and polymorphous vessels including coiled and branched
                                                                         vessels with rounded ending (flower-like vessels) (Figure 1B).
Eccrine porocarcinoma (EPC) is the malignant counterpart                 Ulcerated areas presented polymorphous vascular pattern
of eccrine poroma (EP) and is mostly found on the lower ex-              with linear irregular and dotted vessels with splinter hem-
tremities in elderly adults [1]. EPC may develop as a primary            orrhage (Figure 1C). Histopathology showed that the main
tumor or from a benign long-standing EP with malignant                   lesion was compatible with ulcerated porocarcinoma, in
transformation. Dermoscopy is used increasingly to facilitate            association with an eccrine poroma, invading the inferior
clinical diagnosis [2]. In this report, we describe a case of an         reticular dermis, without vascular and perineural invasion
invasive EPC originating in an eccrine poroma and associ-                (Figure 2, A and B). The satellite lesion was diagnosed as
ated with an adjacent satellite lesion of eccrine poroma.                eccrine poroma. There were no signs of postoperative recur-
                                                                         rence or metastasis after 6 months of follow-up.

Case Presentation
                                                                         Conclusions
A 68-year-old woman referred a vegetative lesion in the right
plantar region with one year of evolution. She reports that              EP is a benign tumor of the sweat gland that arises from
the lesion appeared after local trauma caused by sandals and             acrosyringium. EPC is a rare malignant skin tumor that usu-
complains of pain. On physical examination, it presented as              ally appears in the lower limbs of elderly people as nodule,
an ulcerated, vegetative, bulky exophytic tumor associated               plaque or papule pink to red, sometimes with ulceration [1].
with a satellite small plaque (Figure 1A). Dermoscopy of the             EPC may arise de novo or can originate from malignant
lesion showed predominantly round-to-oval shaped pink                    transformation of an EP [2]. An EP that shows changes, as
white structureless areas surrounded by white-to-pink halo               sudden growth, ulceration and spontaneous bleeding turns



Research Letter | Dermatol Pract Concept. 2022;12(3):e2022135                                                                                  1
Figure 1. Clinical and dermoscopic findings. (A) Clinical presentation of an ulcerated, exophytic tumor in the right plantar region associated
with a satellite small plaque in the metatarsal region. (B) Dermoscopy of the non-ulcerated component showing round-to-oval shaped pink
white structureless areas surrounded by white-to-pink halo (blue asterisks) and polymorphous vessels including coiled and branched vessels
with rounded ending (blue arrows). (C) Dermoscopy of ulcerated areas presented polymorphous vascular pattern with linear irregular and
dotted vessels (black arrows) with splinter hemorrhage (black asterisks).




Figure 2. Histopathological findings. (A) Histology of eccrine poroma showing epidermis with hyperkeratosis and cuboidal poroid nests
with small cuboidal cells in closer examination. (B) Infiltrative tumor with proliferation of epidermis and tumor cells forming ductal lumina.
Closer examination reveals atypical neoplastic cells and some mitotic figures of porocarcinoma.



on the red flag for an arising EPC. In our case the patient              Anatomopathological signs of invasion and cellular pleo-
had both tumors, EP and EPC, and it seems probable that the              morphism in an eccrine tumor are clues to the definitive
EPC originated from the EP.                                              diagnosis [2]. Treatment is necessary due to the aggressive
    According to previously reported, dermoscopic features               nature of the tumor, and surgery is the first option.
may overlap between EPC and EP, such as pink white struc-
tureless areas and white-to-pink halo, although in EPC they
                                                                         References
are present focally in the tumor and do not comprise the
entirety of nodules, such as in EP [1]. Vascular pattern is of-           1. Edamitsu T, Minagawa A, Koga H, Uhara H, Okuyama R.
ten polymorphous in EPC, usually combining hairpin, dotted                   Eccrine porocarcinoma shares dermoscopic characteristics
                                                                             with eccrine poroma: A report of three cases and review of
and linear irregular vessels, while coiled, glomerular and the
                                                                             the published work. J Dermatol. 2016;43(3):332-335. DOI:
typical flower, leaf-like vessels are less frequently found [1].
                                                                             10.1111/1346-8138.13082.
In the histopathological examination the usual findings in-               2. Uchiyama J, Jardim M, Valente N, Camargo MF. The transi-
clude nuclear atypia, increased mitotic activity rate and                    tion between a poroma and a porocarcinoma evidenced by the
necrosis. In the clinical examination, infiltrated borders,                  dermoscopy. An. Bras. Dermatol. 2019;94(2):230-232. DOI:
bleeding, growth and ulceration are important features that                  10.1590/abd1806-4841.20197280. PMID: 31090833; PMCID:
                                                                             PMC6486063.
may indicate malignancy in EP-like lesions [2].
    Since EPC shares multiple features with other tu-
mors and is a rare skin neoplasm, diagnosis is a challenge.




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