History

Malignant eccrine tumors generally present as a single, asymptomatic, nondescript cutaneous lesion. Eccrine carcinomas account for less than 0.01% of all cutaneous appendageal carcinomas.^[13]The most commonly affected age group is those in their seventh decade of life, and it equally affects men and women.

Eccrine carcinomas tend to be solitary, locally invasive lesions that grow slowly over many years; local tumors represent 84.9% of tumors.^[5]Rarely, they may develop quickly, reaching a size of several centimeters over a few months. Metastasis is rare (3.2%).^[5]With disseminated disease, patients may report symptoms related to organ-specific metastases.

Cutaneous/primary lesion of eccrine carcinoma

A solitary nontender, nonencapsulated 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, as follows:

Microcystic adnexal carcinoma (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 ^{[14, 15, 16, 17, 18]}
Aggressive digital papillary adenoma/adenocarcinoma: Typically is seen in males on the digits and adjacent skin
Hidradenocarcinoma: Most occur on the head and neck of older patients
Eccrine porocarcinoma: Most are found on the lower extremities of older adults (see the images below)

Eccrine porocarcinoma. Courtesy of DermNet New Zealand (http://www.dermnetnz.org/topics/eccrine-porocarcinoma/).

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Eccrine porocarcinoma. Courtesy of DermNet New Zealand (http://www.dermnetnz.org/topics/eccrine-porocarcinoma/).

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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.

Complications

Eccrine carcinomas may cause complications secondary to local invasion or metastatic disease.

Differential Diagnoses

Galadari E, Mehregan AH, Lee KC. Malignant transformation of eccrine tumors. J Cutan Pathol. 1987 Feb. 14(1):15-22. [QxMD MEDLINE Link].
Takata M, Hashimoto K, Mehregan P, et al. Genetic changes in sweat gland carcinomas. J Cutan Pathol. 2000 Jan. 27(1):30-5. [QxMD MEDLINE Link].
Biernat W, Peraud A, Wozniak L, Ohgaki H. p53 mutations in sweat gland carcinomas. Int J Cancer. 1998 May 4. 76(3):317-20. [QxMD MEDLINE Link].
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. 2003 Oct. 29(10):1035-8. [QxMD MEDLINE Link].
Gopinath S, Giambarberi L, Patil S, Chamberlain RS. Characteristics and survival of patients with eccrine carcinoma: A cohort study. J Am Acad Dermatol. 2016 Jul. 75 (1):215-7. [QxMD MEDLINE Link].
Quinn KM, Tozbikian G, Carson WE. Concurrent phyllodes tumor, eccrine carcinoma, and multinodular goiter 20 years after radiotherapy for Hodgkin lymphoma. Clin Case Rep. 2018 Dec. 6 (12):2498-2503. [QxMD MEDLINE Link].
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. 2000 Nov. 136(11):1355-9. [QxMD MEDLINE Link].
Harwood CA, McGregor JM, Swale VJ, et al. High frequency and diversity of cutaneous appendageal tumors in organ transplant recipients. J Am Acad Dermatol. 2003 Mar. 48(3):401-8. [QxMD MEDLINE Link].
Kaseb H, Babiker HM. Cancer, Eccrine (Cancer, Syringoid). StatPearls [Internet]. 2019 Jan. [QxMD MEDLINE Link]. [Full Text].
Peterson CM, Ratz JL, Sangueza OP. Microcystic adnexal carcinoma: First reported case in an African American man. J Am Acad Dermatol. 2001 Aug. 45(2):283-5. [QxMD MEDLINE Link].
Gardner ES, Goldberg LH. Neglected microcystic adnexal carcinoma: the second reported case in a black patient. Dermatol Surg. 2001 Jul. 27(7):678-80. [QxMD MEDLINE Link].
Lorente-Luna M, Jiménez Blázquez E, Sánchez Herreros C, Cuevas Santos J. Eccrine Carcinoma: The Role of Mohs Micrographic Surgery and a Review of the Literature. Actas Dermosifiliogr. 2016 Jan-Feb. 107 (1):73-6. [QxMD MEDLINE Link].
Kampshoff JL, Cogbill TH. Unusual skin tumors: Merkel cell carcinoma, eccrine carcinoma, glomus tumors, and dermatofibrosarcoma protuberans. Surg Clin North Am. 2009 June. 89 (3):727-38. [QxMD MEDLINE Link].
Chauhan A, Ganguly M, Takkar P, Dutta V. Primary mucinous carcinoma of eyelid: a rare clinical entity. Indian J Ophthalmol. 2009 Mar-Apr. 57(2):150-2. [QxMD MEDLINE Link]. [Full Text].
Bannur HB, Mastiholimath RD, Malur PR. Primary mucinous eccrine adenocarcinoma of the scalp: a case report. Acta Cytol. 2009 Nov-Dec. 53(6):698-700. [QxMD MEDLINE Link].
Jung YH, Jo HJ, Kang MS. Squamoid eccrine ductal carcinoma of the scalp. Korean J Pathol. 2012 Jun. 46(3):278-81. [QxMD MEDLINE Link]. [Full Text].
Kim JW, Jeon MK, Kang SJ, Sun H. Surgical management of recurrent squamoid eccrine ductal carcinoma of the scalp. J Craniofac Surg. 2012 Jul. 23(4):e276-8. [QxMD MEDLINE Link].
Coan EB, Doan A, Allen C. Mucinous eccrine carcinoma: a rare case of recurrence with lacrimal gland extension. Ophthal Plast Reconstr Surg. 2012 Sep-Oct. 28(5):e109-10. [QxMD MEDLINE Link].
Scholz IM, Hartschuh W. Primary mucinous eccrine carcinoma of the skin - a rare clinical tumor with many differential diagnoses. J Dtsch Dermatol Ges. 2009 Oct 13. [QxMD MEDLINE Link].
Wildemore JK, Lee JB, Humphreys TR. Mohs surgery for malignant eccrine neoplasms. Dermatol Surg. 2004 Dec. 30(12 Pt 2):1574-9. [QxMD MEDLINE Link].
Le LP, Dias-Santagata D, Pawlak AC, Cosper AK, Nguyen AT, Selim MA, et al. Apocrine-eccrine carcinomas: molecular and immunohistochemical analyses. PLoS One. 2012. 7(10):e47290. [QxMD MEDLINE Link]. [Full Text].
Penneys NS, Zlatkiss I. Immunohistochemical demonstration of ferritin in sweat gland and sweat gland neoplasms. J Cutan Pathol. 1990 Feb. 17(1):32-6. [QxMD MEDLINE Link].
Hazkani I, Rabinovics N, Limon D, Silvern D, Koren S, Hadar T, et al. Brachytherapy for radiotherapy-resistant head and neck cancer: A review of a single center experience. Laryngoscope. 2016 Oct. 126 (10):2246-2251. [QxMD MEDLINE Link].
Coan EB, Doan A, Allen C. Mucinous eccrine carcinoma: a rare case of recurrence with lacrimal gland extension. Ophthal Plast Reconstr Surg. 2012 Sep-Oct. 28 (5):e109-10. [QxMD MEDLINE Link].
Moura LR, Ayres B, Feijóo L, Romano S, Odashiro AN, Burnier MN Jr. Presumed eccrine carcinoma metastatic to the choroid. Clin Exp Ophthalmol. 2006 Sep-Oct. 34 (7):699-700. [QxMD MEDLINE Link].
Voutsadakis IA, Bruckner HW. Eccrine sweat gland carcinoma: a case report and review of diagnosis and treatment. Conn Med. 2000 May. 64 (5):263-6. [QxMD MEDLINE Link].
Chhibber V, Lyle S, Mahalingam M. Ductal eccrine carcinoma with squamous differentiation: apropos a case. J Cutan Pathol. 2007 Jun. 34 (6):503-7. [QxMD MEDLINE Link].

Media Gallery

Eccrine porocarcinoma. Courtesy of DermNet New Zealand (http://www.dermnetnz.org/topics/eccrine-porocarcinoma/).
Eccrine porocarcinoma. Courtesy of DermNet New Zealand (http://www.dermnetnz.org/topics/eccrine-porocarcinoma/).
Eccrine carcinoma pathology. Basaloid cells invading the dermis. Courtesy of DermNet New Zealand (http://www.dermnetnz.org/topics/eccrine-carcinoma-pathology/).
Eccrine carcinoma pathology. Tubule and gland formation infiltrating the sclerotic dermis; eccrine differentiation can be seen at high power. Courtesy of DermNet New Zealand (http://www.dermnetnz.org/topics/eccrine-carcinoma-pathology/).
Eccrine carcinoma pathology. Tubule and gland formation infiltrating the sclerotic dermis; eccrine differentiation can be seen at high power. Courtesy of DermNet New Zealand (http://www.dermnetnz.org/topics/eccrine-carcinoma-pathology/).
Eccrine carcinoma pathology. Tubule and gland formation, along with clear cell change. Courtesy of DermNet New Zealand (http://www.dermnetnz.org/topics/eccrine-carcinoma-pathology/).

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Author

Georgina Marie Ferzli, MD, MS Resident Physician, Department of Dermatology, State University of New York Downstate Medical Center

Disclosure: Nothing to disclose.

Coauthor(s)

Aleksandra Lindgren Medical Assistant, Bay Area Cosmetic Dermatology

Disclosure: Nothing to disclose.

Amanda K Doyle, MD Dermatologist, Kline Dermatology

Amanda K Doyle, MD is a member of the following medical societies: Women's Dermatologic Society

Disclosure: Nothing to disclose.

Andrea M Hui, MD Dermatologist, Bay Area Cosmetic Dermatology; Mohs Surgeon, Advanced Skin Care and Dermatology Physicians, Inc, and Redwood Family Dermatology

Disclosure: Nothing to disclose.

Specialty Editor Board

Richard P Vinson, MD Assistant Clinical Professor, Department of Dermatology, Texas Tech University Health Sciences Center, Paul L Foster 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, Texas Medical Association, Association of Military Dermatologists, Texas Dermatological Society

Disclosure: Nothing to disclose.

Chief Editor

Dirk M Elston, MD Professor and Chairman, Department of Dermatology and Dermatologic Surgery, Medical University of South Carolina College of Medicine

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

Disclosure: Nothing to disclose.

Additional Contributors

Daniel Mark Siegel, MD, MS Clinical Professor of Dermatology, Department of Dermatology, State University of New York Downstate Medical Center

Daniel Mark Siegel, MD, MS is a member of the following medical societies: American Academy of Dermatology, American College of Mohs Surgery, American Association for Physician Leadership, American Society for Dermatologic Surgery, American Society for MOHS Surgery, International Society for Dermatologic Surgery

Disclosure: Nothing to disclose.

R Stan Taylor, MD The JB Howell Professor in Melanoma Education and Detection, Departments of Dermatology and Plastic Surgery, Director, Skin Surgery and Oncology Clinic, 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 Medical Association

Disclosure: Nothing to disclose.

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, American College of Mohs Surgery

Disclosure: Nothing to disclose.

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

Disclosure: Nothing to disclose.

Acknowledgements

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

Disclosure: Nothing to disclose.

Aza Lefkowitz, MD Consulting Staff, Advanced Dermatology, PC

Disclosure: Nothing to disclose.