Eccrine Carcinoma Clinical Presentation

Updated: May 30, 2019
  • Author: Georgina Marie Ferzli, MD, MS; Chief Editor: Dirk M Elston, MD  more...
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Presentation

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.

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Physical Examination

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

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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Complications

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

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