Approach Considerations
The literature on treatment of eccrine carcinomas is very sparse.
While surgery remains the treatment of choice, some cases of distant metastases have been treated with radiation therapy. [5]
In one radiotherapy-resistant case of eccrine carcinoma, brachytherapy was used. [23]
Data on the use of chemotherapy for eccrine carcinoma is sparse, and it has not yet proved to be successful for the few listed cases in the literature. [24, 25, 26]
Surgical Care
The treatment of choice is surgical excision of the tumor with negative margins, either by radical surgical excision or Mohs micrographic surgery. [27] As eccrine carcinomas tend to be locally infiltrating and have a propensity for perineural invasion, wide excision is recommended. [27] However, while the clinical experience is limited, the use of Mohs micrographic surgery appears to decrease recurrence rates compared with surgical excision. [20]
Consultations
Surgical oncologists, medical oncologists, and interventional radiologists may play roles in the treatment of patients with eccrine carcinoma.
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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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Eccrine carcinoma pathology. Basaloid cells invading the dermis. Courtesy of DermNet New Zealand (http://www.dermnetnz.org/topics/eccrine-carcinoma-pathology/).
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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/).
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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/).
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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/).