Eccrine Carcinoma Clinical Presentation

  • Author: Anthony Wong, MD, FAAD; Chief Editor: Dirk M Elston, MD   more...
 
Updated: Mar 26, 2010
 

History

  • Malignant eccrine tumors generally present as a single, asymptomatic, nondescript cutaneous lesion.
  • Eccrine carcinomas grow either slowly over years or rapidly, reaching a size of several centimeters over a few months.
  • With disseminated disease, patients may report symptoms related to organ specific metastases.
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Physical

  • Cutaneous/primary lesion of eccrine carcinoma
    • A solitary nodule or plaque on the head or extremities and, less commonly, the trunk is present.
    • Occasionally, the lesion may ulcerate.
    • A few tumor subtypes do exhibit salient clinical features.
      • MAC occurs as an indurated plaque especially in the nasolabial area.
      • Mucinous eccrine carcinoma predominantly involves the eyelids and has also been described on the scalp.[7, 8]
      • Aggressive digital papillary adenoma/adenocarcinoma typically is seen in males on the digits and adjacent skin.
      • Most hidradenocarcinomas occur on the head and neck of older patients.
      • Most eccrine porocarcinomas are found on the lower extremities of older adults.
  • Disseminated eccrine carcinoma disease
    • Nodal and distant metastases may be detected.
    • In particular, eccrine porocarcinoma (the most common eccrine cancer subtype) shows a characteristic propensity to produce multiple cutaneous metastatic deposits concomitant with visceral spread.
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Causes

An etiologic role for UVR has been suggested for eccrine carcinoma. A case of MAC was reported in the neck of a man who received radiation therapy to the site years earlier. In addition, Abbate et al[4] report that 5 out of 10 patients with MAC gave a prior history of radiation therapy. Chiller et al[9] report a potential etiologic role for UVR as they describe MAC predominantly affecting the left side of the face, corresponding to higher UVR exposures while driving.

Immunosuppression has been known to increase the risk of nonmelanoma skin cancers, particularly squamous cell carcinomas. In a 2003 retrospective review of appendageal tumors in organ transplant recipients, Harwood et al[10] suggest that patients who are immunosuppressed have a propensity to also develop cutaneous appendageal tumors over their immunocompetent counterparts, with increased rates of both benign eccrine tumors and malignant eccrine tumors.

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Contributor Information and Disclosures
Author

Anthony Wong, MD, FAAD  Consulting Staff, Department of Dermatology, SUNY Health Science Center at Brooklyn, St Catherine's of Sienna, and Long Island Skin Cancer and Dermatologic Surgery, PC

Anthony Wong, MD, FAAD is a member of the following medical societies: American Academy of Dermatology and American College of Mohs Micrographic Surgery and Cutaneous Oncology

Disclosure: Nothing to disclose.

Coauthor(s)

Darren Keith Mollick, MD  Clinical Assistant Professor, Department of Dermatology, State University of New York Downstate Medical Center

Disclosure: Nothing to disclose.

Daniel Mark Siegel, MD, MS  Director, Procedural Dermatology Fellowship Program, Clinical Professor of Dermatology, Department of Dermatology, State University of New York Downstate

Daniel Mark Siegel, MD, MS is a member of the following medical societies: American Academy of Dermatology, American College of Mohs Micrographic Surgery and Cutaneous Oncology, American College of Physician Executives, American Society for Dermatologic Surgery, American Society for MOHS Surgery, and International Society for Dermatologic Surgery

Disclosure: Nothing to disclose.

Specialty Editor Board

R Stan Taylor, MD  Professor of Dermatology, University of Texas Southwestern Medical School; Director of Skin Surgery and Oncology Clinic, Department of Dermatology, University of Texas Southwestern Medical Center

R Stan Taylor, MD is a member of the following medical societies: American Academy of Dermatology, American College of Mohs Surgery, American Dermatological Association, American Medical Association, American Society for Dermatologic Surgery, Christian Medical & Dental Society, and Society for Investigative Dermatology

Disclosure: Nothing to disclose.

Richard P Vinson, MD  Assistant Clinical Professor, Department of Dermatology, Texas Tech University School of Medicine; Consulting Staff, Mountain View Dermatology, PA

Richard P Vinson, MD is a member of the following medical societies: American Academy of Dermatology, Association of Military Dermatologists, Texas Dermatological Society, and Texas Medical Association

Disclosure: Nothing to disclose.

Mary Farley, MD  Dermatologic Surgeon/Mohs Surgeon, Anne Arundel Surgery Center

Disclosure: Nothing to disclose.

Glen H Crawford, MD  Assistant Clinical Professor, Department of Dermatology, University of Pennsylvania School of Medicine; Chief, Division of Dermatology, The Pennsylvania Hospital

Glen H Crawford, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Medical Association, Phi Beta Kappa, and Society of USAF Flight Surgeons

Disclosure: Nothing to disclose.

Chief Editor

Dirk M Elston, MD  Director, Department of Dermatology, Geisinger Medical Center

Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

References

  1. Galadari E, Mehregan AH, Lee KC. Malignant transformation of eccrine tumors. J Cutan Pathol. Feb 1987;14(1):15-22. [Medline].

  2. Takata M, Hashimoto K, Mehregan P, et al. Genetic changes in sweat gland carcinomas. J Cutan Pathol. Jan 2000;27(1):30-5. [Medline].

  3. Biernat W, Peraud A, Wozniak L, Ohgaki H. p53 mutations in sweat gland carcinomas. Int J Cancer. May 4 1998;76(3):317-20. [Medline].

  4. Abbate M, Zeitouni NC, Seyler M, Hicks W, Loree T, Cheney RT. Clinical course, risk factors, and treatment of microcystic adnexal carcinoma: a short series report. Dermatol Surg. Oct 2003;29(10):1035-8. [Medline].

  5. Peterson CM, Ratz JL, Sangueza OP. Microcystic adnexal carcinoma: First reported case in an African American man. J Am Acad Dermatol. Aug 2001;45(2):283-5. [Medline].

  6. Gardner ES, Goldberg LH. Neglected microcystic adnexal carcinoma: the second reported case in a black patient. Dermatol Surg. Jul 2001;27(7):678-80. [Medline].

  7. Chauhan A, Ganguly M, Takkar P, Dutta V. Primary mucinous carcinoma of eyelid: a rare clinical entity. Indian J Ophthalmol. Mar-Apr 2009;57(2):150-2. [Medline].

  8. Bannur HB, Mastiholimath RD, Malur PR. Primary mucinous eccrine adenocarcinoma of the scalp: a case report. Acta Cytol. Nov-Dec 2009;53(6):698-700. [Medline].

  9. Chiller K, Passaro D, Scheuller M, Singer M, McCalmont T, Grekin RC. Microcystic adnexal carcinoma: forty-eight cases, their treatment, and their outcome. Arch Dermatol. Nov 2000;136(11):1355-9. [Medline].

  10. Harwood CA, McGregor JM, Swale VJ, et al. High frequency and diversity of cutaneous appendageal tumors in organ transplant recipients. J Am Acad Dermatol. Mar 2003;48(3):401-8. [Medline].

  11. Scholz IM, Hartschuh W. Primary mucinous eccrine carcinoma of the skin - a rare clinical tumor with many differential diagnoses. J Dtsch Dermatol Ges. Oct 13 2009;[Medline].

  12. Wildemore JK, Lee JB, Humphreys TR. Mohs surgery for malignant eccrine neoplasms. Dermatol Surg. Dec 2004;30(12 Pt 2):1574-9. [Medline].

  13. Penneys NS, Zlatkiss I. Immunohistochemical demonstration of ferritin in sweat gland and sweat gland neoplasms. J Cutan Pathol. Feb 1990;17(1):32-6. [Medline].

  14. Yeung KY, Stinson JC. Mucinous (adenocystic) carcinoma of sweat glands with widespread metastasis. Case report with ultrastructural study. Cancer. Jun 1977;39(6):2556-62. [Medline].

  15. Snow S, Madjar DD, Hardy S, et al. Microcystic adnexal carcinoma: report of 13 cases and review of the literature. Dermatol Surg. Apr 2001;27(4):401-8. [Medline].

  16. Lozano Orella JA, Valcayo Penalba A, San Juan CC, et al. Eccrine porocarcinoma. Report of nine cases. Dermatol Surg. Oct 1997;23(10):925-8. [Medline].

  17. Mehregan AH, Hashimoto K, Rahbari H. Eccrine adenocarcinoma. A clinicopathologic study of 35 cases. Arch Dermatol. Feb 1983;119(2):104-14. [Medline].

  18. Lober CW, Larbig GG. Microcystic adnexal carcinoma (sclerosing sweat duct carcinoma). South Med J. Feb 1994;87(2):259-62. [Medline].

  19. Moy RL, Rivkin JE, Lee H, Brooks WS, Zitelli JA. Syringoid eccrine carcinoma. J Am Acad Dermatol. May 1991;24(5 Pt 2):857-60. [Medline].

  20. Duke WH, Sherrod TT, Lupton GP. Aggressive digital papillary adenocarcinoma (aggressive digital papillary adenoma and adenocarcinoma revisited). Am J Surg Pathol. Jun 2000;24(6):775-84. [Medline].

  21. Cabell CE, Helm KF, Sakol PJ, Billingsley EM. Primary mucinous carcinoma in a 54-year-old man. J Am Acad Dermatol. Nov 2003;49(5):941-3. [Medline].

  22. Cooper PH, Adelson GL, Holthaus WH. Primary cutaneous adenoid cystic carcinoma. Arch Dermatol. Jun 1984;120(6):774-7. [Medline].

  23. Goel R, Contos MJ, Wallace ML. Widespread metastatic eccrine porocarcinoma. J Am Acad Dermatol. Nov 2003;49(5 Suppl):S252-4. [Medline].

  24. Harrist TJ, Aretz TH, Mihm MC Jr, Evans GW, Rodriquez FL. Cutaneous malignant mixed tumor. Arch Dermatol. Nov 1981;117(11):719-24. [Medline].

  25. Hashimoto K, Mehregan AH, Kumakiri M. Tumors of Skin Appendages. Boston, Mass: Butterworth; 1987.

  26. Mitsui H, Watanabe T, Jinnin M, Kadono T, Idezuki T, Tamaki K. Mucinous carcinoma of the skin could have either an eccrine or an apocrine origin. Br J Dermatol. Dec 2004;151(6):1285-6. [Medline].

  27. Murphy GF, Elder DE. Non melanocytic tumors of the skin. In: Atlas of Tumor Pathology. 3rd Series. Fascicle 1. Washington DC: Armed Forces Institute of Pathology; 1991.

  28. Wick MR, Swanson PE, Kaye VN, Pittelkow MR. Sweat gland carcinoma ex eccrine spiradenoma. Am J Dermatopathol. Apr 1987;9(2):90-8. [Medline].

  29. Yildirim S, Aköz T, Akan M, Ege GA. De novo malignant eccrine spiradenoma with an interesting and unusual location. Dermatol Surg. Apr 2001;27(4):417-20. [Medline].

 
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