Site Editor
Soo Park, MD
Soo Park, MD
Posted: Wednesday, July 13, 2022
How rare is eccrine porocarcinoma occurring on the face? Extremely, according to the findings of a recent retrospective review. In fact, of 3,984 confirmed facial skin cancers excised between January 2010 and June 2021 in a tertiary hospital’s plastic surgery department, just 4 were histologically confirmed eccrine porocarcinoma, wrote Konstantinos Seretis, MD, MSc, of Ioannina University School of Medicine, Greece, and colleagues in Dermatology Practical & Conceptual.
“Clinical awareness ought to be raised and a definitive treatment protocol be established for optimized results,” the authors stated.
The investigators aimed in their study to evaluate not only the frequency but the clinical features and malignancy course of face-located eccrine porocarcinoma. More commonly, they explained, this subtype of non-melanoma skin cancer, “branded with highly metastatic potential,” is seen on the extremities, and patients are generally elderly.
Eccrine porocarcinoma develops in the intraepithelial portion of eccrine sweat glands, noted Dr. Seretis and co-investigators. It usually presents as an asymptomatic solitary nodule or mass that can remain noticed but not of concern to the patient for up to several years. Or it can mimic other skin conditions, including seborrheic keratosis, pyogenic granuloma, amelanotic melanoma, squamous cell carcinoma, and verruca vulgaris.
None of the four cases was initially suspected clinically. “The diagnosis [followed] the histopathologic examination,” they pointed out, adding that such an examination is essential to confirm the diagnosis, identify the histologic subtype, and guide further treatment. Two of the four cases included “aggressive postoperative behavior.”
Once it is diagnosed, wide local excision is the optimal treatment. “All lesions should be excised with 3-mm clear margins and a further 5-mm margin must be achieved using a modified Mohs technique, should the ‘infiltrative’ or the ‘pagetoid’ subtypes be confirmed,” directed the team. Earlier diagnosis would serve patients well: “Vigilance is mandatory for prompt recognition and treatment to avoid the high mortality rates reported.”
Disclosure: The study authors reported no conflicts of interest.
Dermatology Practical & Conceptual
JNCCN Spotlights
