A Case of Recurrence Eccrine porocarcinoma in a 95-year-old Woman

Introduction:Eccrine poro-carcinoma (EP) is a rare malignant cutaneous appendageal tumor That developsfrom the intra-epidermal eccrine sweat duct. It represents only 0.005% of epithelialCutaneous neoplasms, and occurs in order people,(range 19-67years). Less than 20% ofeccrine Procarcinomas recur after excision. This case has two unique features, recurrenceafter 3 years and occurring at unusual age.Case Report:We report a case of 95-year-old woman with a large tumor of the left knee. Physicalexamination of her lesion revealed a large, red, exophytic, circumscribed tumor withoutevidence of involved lymph nodes or distant metastasis. She had a similar lesion 3 years ago(2006). The sections of 2006 biopsy showed skin and underlying tissues containing a highlyinfiltrative adnexal carcinoma. The tumor was composed predominantly of nests of epithelialcell, with roundednuclei and vacuolated cytoplasm lying myxoid stroma. Some cells havecytoplasmic vacuoles. There were many mitotic figures present. Areas of squamousdifferentiation were also present together with focal differentiation to from ductal lumina.These areas awere most consistent with porocarcinoma. In some areas of the tumor, there wasabundant myxoid stroma. That is unusual for porocarcinoma and suggests chondroidsyringoma. The neoplasm has highly infiltrative growth pattern extending to all the marginsof the biopsy. The tumor showed immunolabeling of a large percentage of the cells for p63supporting squamous or myoepithelial differentiation. Most the cells were also positive forCK7, EMA and CEA highlighted luminal differentiation in some of the vacuolated cells andthis is also seen with the PAS-diastase stain. Sections of 2009 excision showed a recurrenceof the tumor that has an identical morphology to that presented in 2006. Extensive areas ofnecrosis were seen. The recurrent tumor again appears to have been incompletely excised.She is still alive and her lesion has not recurred.