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Background: Squamoid eccrine ductal carcinoma (SEDC) represents a subtype of eccrine carcinomas that are diagnostically challenging for both clinicians and dermatopathologists., Objective: To provide an updated review of SEDC and examine patient outcomes with different treatment modalities., Methods: A review of Ovid MEDLINE was performed to review the English language medical literature of SEDC., Results: A comprehensive review of clinical presentation, histologic findings, rates of lymphovascular and metastatic disease, treatment modalities and recurrence rates are reviewed., Limitations: There is a limitation on available data because of the rare incidence., Conclusions: SEDC is a rare adnexal neoplasm with a relatively high rate of local recurrence, lymphovascular invasion, perineural invasion, and metastases. Clinicians should be aware of this entity as close follow-up is essential to detect recurrence and metastatic disease. Mohs micrographic surgery seems to result in superior patient outcomes., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.)

Rationale: Eccrine poroma, a benign cutaneous neoplasm originating from the intraepidermal portion of the eccrine sweat duct, is relatively common in clinical practice. Nevertheless, the 1 presenting as spindle-shaped plaque is extremely rare and easily misdiagnosed as seborrheic keratosis or other dermatoses. Thus, the current study demonstrates a case of eccrine poroma with unique clinical manifestation., Patients Concerns: A 47-year-old man presented with a spindle-shaped plaque on his left sole for 6 years., Diagnoses: Based on the clinical and histopathological manifestations, diagnosis of eccrine poroma was established., Interventions: Surgical excision under local anesthesia was performed., Outcomes: No recurrence or malignant transformation occurred within 6-month follow-up., Lessons: Eccrine poroma typically presents as a dome-shaped nodule on palm or sole. But this case reminded us the lesion presenting as a spindle-shaped plaque on sole can not rule out the possibility of eccrine poroma., Competing Interests: The authors have no funding and conflicts of interests to disclose., (Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.)

BACKGROUND Syringoid eccrine carcinoma (SEC) is an extremely rare malignant adnexal neoplasm derived from eccrine sweat glands, of unknown pathogenesis. We report a case of this rare entity presenting in the abdomen, which is the only one reported in this area and the only case of SEC in a patient with so many comorbidities. CASE REPORT A 58-year-old black male from Brazil reported a nodular lesion in the abdomen with a progressive increase in size and pain and local burning sensation. The histopathological examination showed a syringoid eccrine carcinoma. CONCLUSIONS We present a rare case of SEC and did an extensive literature review in order to describe the clinical characteristics, histopathological findings, immunohistochemical profile, treatments, and difficulties found in the diagnosis of this tumor. To avoid misdiagnosis, we gave special attention to biopsy quality.

Eccrine poroma is a rare benign adnexal neoplasm originating from a portion of the intraepidermal eccrine sweat gland duct and the acrosyringium. Typically, the lesions are asymptomatic, slow-growing nodules, which may be found in any sweat gland-bearing area. Multiple red lacunae, glomerular vessels, hairpin vessels, flower- and leaf-like vascular patterns, a polymorphic vascular pattern, globule/lacunae-like structures, a frog egg-like appearance, and comedo-like openings have been defined as characteristic dermoscopic patterns of the disease. We report a case of eccrine poroma in an unusual periungual and subungual location mimicking ingrown toenails. The dermoscopic findings of the lesions were compatible with those of eccrine poromas located in areas other than the periungual area. Recurrence was observed after the first excisional biopsy. There was no recurrence 10 months after the second surgical intervention, and near-complete regrowth of the nail plate was achieved. Eccrine poroma should be considered as a differential diagnosis in the presence of slow-growing, erythematous, painful, hemorrhagic papular lesions located in the periungual area in conjunction with a prediagnosis of ingrown toenails and malignant processes.

An 85-year-old man presented with an ulcerated pruritic nodule on the scalp. Histology of a deep curette specimen showed the typical features of a squamoid eccrine ductal carcinoma: superficial squamous differentiation and deep ductal structures., (© 2015 The Australasian College of Dermatologists.)

Eccrine syringofibroadenoma is a rare benign adnexal neoplasm derived from cells of the acrosyringium of eccrine sweat glands. ESFA usually manifests as a solitary nodule on the extremities of elderly patients, but it may also present as papules, nodules or plaques. Its clinical appearance is nonspecific and malignant neoplasms should be considered in the differential diagnosis. However, histopathological findings are typical. The main treatment is surgical excision. In order to illustrate a typical presentation of the tumor, we report a case of solitary eccrine syringofibroadenoma, including the surgical treatment used and its result.

Background: Eccrine angiomatous hamartoma (EAH) is a rare benign cutaneous tumor characterized by the proliferation of eccrine glands and capillaries., Objective: The aim of this study was to summarize the clinicopathological characteristics of EAH., Methods: A retrospective chart review was performed on all patients diagnosed with EAH from 1977 to 2012 in the Union Hospital, Wuhan, P.R. China, and the clinicopathological features were compared with the cases reported in the literature., Results: A total of 26 patients with EAH were identified. The male:female ratio was 1.2:1. EAH most commonly presents as a solitary (80.8%) plaque (50.0%) on the lower extremities (61.5%). Most patients presented with hyperhidrosis localizing to the lesion. Although most patients did not have major pain or anatomic deformity, one patient had severe pain as well as difficulty walking and moving, necessitating leg amputation. The histopathological findings showed typical features of EAH., Conclusion: EAH is a rare but characteristically benign skin hamartomatous condition. In rare occasions it can be associated with severe structural and functional impairment., (© 2015 S. Karger AG, Basel.)

A 46-year-old woman was evaluated for a "recurring papilloma" of the left medial upper eyelid margin. Beneath the papillary lesion medial to the punctum was a 5-mm diameter cutaneous mass thought to be cystic. After excisional biopsy, histopathologic analysis documented the presence of an epidermal keratinizing squamous papilloma surmounting a circumscribed dermal papillary hidradenoma composed of deeply eosinophilic columnar cells. Additionally, there was intraductal proliferation of tumor extending toward a subclinical poral opening through the epidermis. Immunohistochemistry proved the apocrine nature of the benign, non-cystic lesion by virtue of its nuclear androgen receptor and cytoplasmic gross-cystic disease fluid protein-15 positivity, along with its smooth muscle actin-positive myoepithelial layer. This and prior cases establish that apocrine tumors, both benign and malignant, are strictly localized at or near the eyelid margin where only apocrine glands are found. These tumors are more often papillary than solid adenomas, and most exceptionally can be malignant. We review the differential diagnosis of simulating eccrine eyelid tumors. We recommend wide local excision for benign lesions, in view of possible intraductal extension that can be eccentric to the main tumor and the miniscule potential for malignant transformation., (Copyright © 2014 Elsevier Inc. All rights reserved.)

Syringoid eccrine carcinoma is a very rare skin cancer. We present a case of a 22-year-old woman with a presentation of syringoid eccrine carcinoma in the subungual region of the hallux. This clinical case demonstrates our work-up that led to a proper diagnosis and management of this pathology. We discuss our surgical procedure of choice and the outcome. This report adds valuable information to a limited database of knowledge available on the diagnosis and management of syringoid eccrine carcinomas.

Malignant eccrine spiradenoma (MES) is an extremely rare but aggressive tumour, resulting in high mortality. We report the first case in the UK of metastatic MES on the scalp of a 37-year-old man who initially presented with a raised nodular mass which had grown rapidly over a few months. Excision biopsy of the lesion was performed and histology confirmed MES with evidence of cytological atypia and necrosis. A further wide local excision of the lesion with a 1 cm surgical margin was performed and full clearance was achieved. At 10-month follow-up another similar lesion had developed close to the previously excised area. A CT scan demonstrated metastatic lesions in the lungs, liver and pelvis, and subsequently chemotherapy was initiated. Although MES is uncommon, it has a high propensity to metastasise, therefore prompt identification, treatment and close follow-up of these tumours is essential., (2014 BMJ Publishing Group Ltd.)

Primary mucinous carcinoma of the skin is a rare malignant neoplasm, often with periocular involvement, believed to originate from eccrine sweat glands. It is slow growing and locally destructive, at times forming tumour satellites. We present a case with six local recurrences treated with surgical resections over a period of 30 years. We have not been able to find longer follow-up in the literature, and believe this case may offer insight into the management of these uniquely indolent malignancies.

Squamoid eccrine ductal carcinoma (SEDC) is an exceedingly rare tumor that shows both squamous differentiation and adnexal ductal differentiation. As our review of the literature revealed, only a total of 7 cases were reported to date. We report an additional case of SEDC occurring on the scalp of a 53-year-old man. Despite complete excision by conventional technique with clear margin, the lesion recurred within a 3-month period, with regional lymph node metastasis. The tumor was completely removed, and the large scalp defect was reconstructed by using scalp rotation flap. We present a case of recurrent SEDC on the scalp, and we surgically resected this tumor. In addition, the large scalp defect was reconstructed successfully with scalp flap, and no recurrence has been observed in the patient's postoperative follow-ups.

We recently observed atypical adenomatous metaplasia of eccrine glands in an excisional biopsy of squamous cell carcinoma (SCC). This led us to this study in an effort to ascertain whether this reaction pattern is common to all excisional biopsies and, depending on its presence in association with residual tumor, whether it is lineage specific. We performed a retrospective review of 201 excisional biopsies and noted that adenomatous metaplasia was present in 35 of 201 (17%) of the cases, of which 19 had residual tumor. Adenomatous metaplasia seemed to be more frequent in epithelial neoplasms such as basal cell carcinomas 15 of 94 (16%) and SCCs 13 of 61 (21%) although only (3 of 41) 7% of nevomelanocytic proliferations exhibited this change. Residual tumor was noted in association with adenomatous metaplasia, in 11 of 15 cases (73%) in the basal cell carcinoma subgroup, in 8 of 13 cases (62%) in the SCC subgroup, and in none from the nevomelanocytic subgroup. Comparing frequencies of adenomatous metaplasia across groups, only SCC specimens with residual tumor demonstrated a statistically significant increase compared with nevomelanocytic neoplasm (35% vs. 7%, P = 0.01). Findings from the current study expand the spectrum of metaplastic change involving eccrine glands to include adenomatous metaplasia. Given that it seems to be more common to epithelial malignancies, it seems reasonable to posit that this reaction pattern is the consequence of hitherto undefined proteins induced by epithelial tumor cells resulting in exuberant stimulation of eccrine glands, although immunohistochemical and molecular studies are required to define the precise cause.

Chondroid syringoma is a rare eccrine tumor that is often benign but has the potential for malignant transformation and distant metastasis. Histopathological analysis may not be definitive, and any patient with atypical features, an accelerated clinical course, or high suspicion for malignant transformation is a candidate for immediate surgical intervention and close follow-up. The purpose of this article is to review the clinical features of this rare tumor with a special emphasis on its atypical presentation., (Copyright © 2011 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.)

Collision tumors of the vulva are uncommon. Mammary-type myofibroblastoma is a rare benign tumor arising at extramammary sites with morphological and immunophenotypic features similar to the breast counterpart. Eccrine adenocarcinoma of the vulva is rare. The authors report here a true collision tumor containing a mammary-type myofibroblastoma with intermingling components of eccrine adenocarcinoma occurring in the vulva. An 80-year-old woman presented with a subcutaneous nodule in the vulva. The tumor was well circumscribed but unencapsulated. The mammary-type myofibroblastoma and the adenocarcinoma measured 4 cm × 3.5 cm × 1.0 cm and 1.5 cm × 1.2 cm × 0.8 cm, respectively. In the overlying superficial dermis there was an eccrine adenocarcinoma. It was composed of uniform basophilic cells arranged in tubules, solid nests, and cribriform growth patterns. The eccrine adenocarcinoma infiltrated the mammary-type myofibroblastoma in the submucosa. The soft tissue lesion revealed a spindle cell proliferation composed of fascicles of myofibroblastic cells embedded in a collagenous stroma with a predominance of mast cells. Interspersed thick hyalinized collagen bundles separated the fascicles. Immunohistochemically, the spindle cell tumor strikingly stained for both CD34 and desmin. To the best of our knowledge, this is the first case report of a vulva collision tumor composed of mammary-type myofibroblastoma intermixed with primary eccrine adenocarcinoma in the English literature., (© 2011 The Authors. Pathology International © 2011 Japanese Society of Pathology and Blackwell Publishing Asia Pty Ltd.)

First described in 1969, syringoid eccrine carcinoma (SEC) is a rare cutaneous tumor with some controversy regarding its correct definition. It consists of solid nests and small cords in a dense fibrocollagenous stroma. As it is rare, its clinical appearance is not well characterized and its biological behaviour is not defined. It usually affects skin of the scalp, extremities and more rarely, other sites. It behaves as locally aggressive tumor but metastases are rare. Although there have been some previous reports describing clinical presentation and management of SEC in the skin, there has been no previous reports describing clinical findings and management of this tumor in the external auditory canal. We report a case of a 57-year-old female with small solitary mass in left external auditory canal associated with discharge, severe itching and bleeding on manipulation. Complete local excision is the recommended method for diagnosis and treatment of this tumor in the external auditory canal. This extremely rare case serves as a springboard for the diagnosis as well as the management of SEC in external auditory canal., (Copyright 2010 Elsevier Ireland Ltd. All rights reserved.)

Eccrine ductal carcinoma is a rare adnexal tumor. Squamoid eccrine ductal carcinoma (SEDC) represents an exceptionally rare variant with only 6 cases reported to date. This neoplasm is deeply infiltrative and may provide a diagnostic challenge in superficial shave biopsies of skin. We present a case of SEDC in an immunocompromised patient, who, after an initial shave biopsy for diagnostic purposes, underwent a complete excision of his tumor by Mohs micrographic surgery. A combined histologic and immunohistochemical approach is necessary to identify and confirm the unique characteristics of SEDC. Because this cancer is very rare and little is known about its biologic behavior, optimal diagnostic and treatment guidelines need to be developed.

Background: Eccrine glands (sweat glands) appear in all sites of the skin and are more abundant in hands and feet. Nodular hidradenocarcinoma (NH) is a rare malignant and aggressive tumor of the eccrine glands. The objective of this study is to report a case of perianal hidradenocarcinoma., Clinical Case: We present the case of a 75-year-old female with diabetes, hypertension, and hypothyroidism. Physical examination revealed a small perianal tumor that was palpated near the anal canal. Biopsy was done. Pathology report revealed perianal hidradenoma. Rectosigmoidoscopy was normal. Computed tomography showed 1-cm adenopathies in inguinal and right iliac regions. Extensive resection of the tumor was done. Definitive pathology report was malignant eccrine acrospiroma. The patient underwent adjuvant chemotherapy in the Oncology Service and died 1 month later., Conclusions: In patients with a first symptom of metastases in the inguinal region, suspicion must be directed to the anal canal.

Objective: To report on patients with mucinous eccrine adenocarcinoma of the eyelid., Design: Retrospective case series., Participants: Biopsy specimens of 6 patients with eyelid neoplasm were obtained. The pathologic diagnoses were mucinous eccrine adenocarcinomas., Methods: The medical records, including demographic, clinical, histopathologic, and follow-up information, were reviewed., Results: Five patients underwent surgical removal of the lesion by means of Mohs micrographic surgery. Four of these patients were doing well; 1 of them, with positive margins of resection, had 2 recurrences. One case was lost to follow-up., Conclusions: Mucinous eccrine adenocarcinoma is an uncommon adnexal tumour that can involve the eyelid, has low metastasis and mortality, but can be invasive or locally recur. Mohs micrographic surgery is a recommended treatment of mucinous eccrine adenocarcinoma of the eyelid.

Purpose: Presentation of a case of very rare malignant tumor of eccrine sweat glands in the eyelid., Material and Methods: A 44 years old man with a tumor of the upper left eyelid is presented., Conclusions: Sweat gland carcinomas are rare malignant tumors of the skin adnexa. Diagnosis of these carcinomas is difficult due to their infrequency.

The authors report a rare case of primary mucinous eccrine adenocarcinoma of the skin initially diagnosed as metastatic adenocarcinoma and treated with local excision and adjuvant radiotherapy in another center. The tumor reoccurred in the left axilla 2.5 years later after the initial treatment. Diagnosis in our center was primary cutaneous eccrine mucinous adenocarcinoma. We present the clinical, histological, and immunohistochemical features of this rare tumor in the light of the searched literature.

We report the third case of eccrine syringofibroadenoma (ESFA) arising in peristomal skin. A 55-year-old man presented with a 15- x 10-cm pale pink verrucous, exophytic, intermittently tender plaque involving his ileostomy site. He had undergone proctocolectomy with ileostomy creation 33 years prior for ulcerative colitis. The clinical differential diagnosis included granulomatous dermatitis, infection (fungus or atypical mycobacterium), or neoplasm. A punch biopsy specimen was performed and showed ESFA. Although ESFA is considered to be benign, recent reports have demonstrated an association of ESFA with malignancy or malignant transformation of ESFA. Furthermore, ESFA and reported cases of ileostomy carcinoma share similar clinical symptoms at presentation including pain, irritation, ulceration, bleeding, and the presence of a fungating mass. The lesion was, therefore, excised in toto and the excisional specimen showed no evidence of malignancy. We speculate that ESFA is a reaction to chronic irritation and, analogous to other long-standing reactive processes such as lichen sclerosis or burn scar ulcers, may be associated with malignant transformation. Because of this possibility and the clinical overlap with ileostomy carcinoma, peristomal ESFA should be treated with complete excision. If it is not amenable to complete excision because of lesion size or anatomic complexity, generous sampling and close clinical follow-up are recommended.

Eccrine syringofibroadenoma (ESFA) is a rare, benign adnexal tumor arising most often on the extremities of elderly individuals. It is typically a slow-growing, flesh- to reddish-colored nodule or plaque. Histologically, the tumor consists of anastomosing cords of cuboidal epithelial cells surrounded by a fibrovascular stroma containing plasma cells. The cords contain scattered ductal structures lined with cuboidal cells resembling eccrine ducts. The co-existence of ESFA with squamous cell carcinoma has been described, eliciting the term eccrine syringofibroadenoma. The differential diagnosis includes poroma, porocarcinoma, fibroepithelioma of Pinkus and clear cell acanthoma. ESFA stain positively with epithelial membrane antigen and carcinoembryonic antigen. Cytokeratin studies have been inconsistent.

Case Report: A 58-year-old white female noted a lesion on her left lower eyelid, present for 3 months. Examination disclosed a dark-blue, subepithelial, smooth mass along the cilia near the punctum. The lesion did not transmit light and was thought to be a solid mass, such as a deep-blue nevus or melanoma versus a cystic mass with internal debris. Ultrasound biomicroscopy showed a fairly circumscribed echolucent mass measuring 3.2 x 3.5 mm suggestive of a cyst with numerous internal echo impedances. Following resection, histopathologic evaluation disclosed a cyst lined by a dual layer of eccrine sweat ductal epithelium, consistent with eccrine hidrocystoma., Comments: Eyelid hidrocystomas can be pigmented and can be confused clinically with melanocytic tumors. Ultrasound biomicroscopy can provide helpful diagnostic information about the internal architecture of such lesions.

Sweat gland carcinomas are rare. Given this, they can pose a diagnostic challenge especially in shave biopsy specimens. We present a case of ductal eccrine carcinoma with extensive squamoid differentiation that was repeatedly misdiagnosed by multiple dermatopathologists as squamous cell carcinoma in the initial few biopsies. As the distinction between these two neoplasms is crucial to patient management, we highlight the histologic features of this uncommon entity to highlight the potential diagnostic pitfalls.

Malignant eccrine poroma was first described by Pinkus and Mehregon in 1963. Because of the histologic characteristics of the tumor, these authors concluded that the tumor was likely of eccrine origin. Malignant eccrine poroma originates from the intraepidermal ductal portion of the eccrine gland. Like other tumors of skin adnexa, malignant eccrine poroma is a rare tumor. It mostly affects older persons. Clinical diagnosis is difficult, and lesions are often mistakenly identified as squamous cell carcinoma or pyogenic granuloma. We report a case of malignant eccrine poroma invading the parotid gland. A 65-year-old man presented with an ulcerated mass (2x3 cm) below the ear lobule of 3 months' duration. The mass was fixed to the skin and underlying parotid gland. The lesion was treated using a superficial parotidectomy approach including the overlying skin. Simultaneous neck dissection was performed. The diagnosis was malignant eccrine poroma invading the parotid gland.

Background: Squamoid eccrine ductal carcinoma is a rare cutaneous malignancy. There are no accepted standards for surgical margins in eccrine carcinomas., Objective: We report a case of squamoid eccrine ductal carcinoma resembling squamous cell carcinoma and discuss Mohs micrographic surgery as a surgical modality for eccrine carcinomas., Method: The patient was a 30-year-old Korean woman with a 4-year history of a nodule on her neck. Following primary diagnosis of squamous cell carcinoma by punch biopsy, the tumor was completely removed by Mohs micrographic surgery with a 2 mm cancer-free margin., Result: A one-stage Mohs micrographic surgical procedure was performed, and the size of the tumor mass was 2.3 x 2.5 cm in width and 1.5 cm in depth. On histopathologic examination, the tumor was characterized by both eccrine and squamous differentiation. The squamous cells expressed epithelial membrane antigen and cytokeratin 5 and 6, and the cells forming ductal structures expressed anti-carcinoembryonic antigen. Although eccrine carcinomas show a generally aggressive clinical course, the patient was disease free at 14 months after surgery., Discussion: Squamoid eccrine ductal carcinoma should be considered in the differential diagnosis of squamous cell carcinoma and other cutaneous adnexal neoplasms showing squamoid and ductal features of differentiation. In addition, Mohs micrographic surgery can be an option sufficient for complete surgical removal of eccrine carcinomas such as squamoid eccrine ductal carcinoma.

A 75-year-old Caucasian man presented with foreign-body-type irritation of the left eye. Physical examination revealed a 12 x 10-mm nodule in his left upper eyelid, which reportedly had been present unchanged for more than 40 years. No other ophthalmological abnormalities were present. Incisional biopsy of the lesion revealed a malignant tumour that was thought to possibly represent a sebaceous carcinoma. However, a subsequent wide surgical excision showed that the tumour was an eccrine porocarcinoma, a rare sweat gland adenocarcinoma arising from the acrosyringium.

Background: While squamous cell carcinoma and pseudocarcinomatous hyperplasia have been documented as pre-existing lesions in cases of reactive eccrine syringofibroadenoma (ESFA), to the best of our knowledge carcinoma occurring in a solitary ESFA has not yet been reported. We present one such case in a 91-year-old female who had a dome-shaped, reddish tumor on the extensor side of the left forearm., Methods: We review the histopathological, immunophenotypical and ultrastructural findings of this tumor, including the keratin expression profile., Results: Histopathologically, long, branching, anastomosing, thin and thick strands of small cuboidal epithelial cells were extending from the surface epidermis into the dermis. In the center of the tumor, there were irregular-shaped nests of atypical tumor cells invading downward into the dermis. Ultrastructurally, duct-like lumina lined with cuboidal tumor cells were present in the epithelial cords. From these findings, the present case was diagnosed as solitary eccrine syringofibroadenocarcinoma (ESFAC). Keratin expression studies revealed that cells of the thick strands, except for the luminal and basal cells, were positive for differentiation-specific keratins, keratins 1 and 10, and that cells of the thin strands were positive for keratins 5 and 14., Conclusions: Histopathological, immunophenotypical and ultrastructural evidence, as well as the pattern of keratin expression, suggest differentiation of the present malignant tumor towards the eccrine dermal duct. This case is the first reported case of ESFAC as far as we know.

Eccrine syringofibroadenoma (ESFA) is a benign neoplasm arising from the intraepidermal portion of eccrine ducts. It is characterized by a distinctive histologic pattern of epithelial cells arranged in anastomosing cords surrounded by a fibrovascular stroma. Approximately 50 cases of ESFA have been reported, and in recent years the lesion has been described occurring in association with other skin conditions. We report 2 cases of ESFA arising in abdominal skin adjacent to enterostomy sites.

Background: Papillary eccrine adenoma (PEA) is a rare benign sweat gland neoplasm first described by Rulon and Helwig in 1977. Although these lesions typically behave in a benign fashion, PEA's on the volar surfaces may demonstrate more aggressive biologic behavior. Additionally, aggressive digital papillary adenomas (ADPA) may histologically simulate PEAs and behave in a more malignant fashion., Objective: To present a case report of a patient with an incompletely excised PEA that was successfully extirpated using Mohs micrographic surgery (MMS)., Methods: A 51-year-old black woman was evaluated for the treatment of an incompletely excised PEA located on the dorsum of her left hand at the base of the thumb. Mohs micrographic surgery was felt to be the ideal treatment choice because of incomplete prior resections, ill-defined clinical borders, the need for conservative surgical excision to preserve sensory and motor function of the left hand, and the previously reported more aggressive nature of this tumor when located on volar surfaces. The patient underwent a two-stage, six section micrographically controlled excision using the fresh tissue technique., Results: Complete resection of the PEA without significant damage to neurovascular structures., Conclusion: This case demonstrates the increasingly important role MMS is playing in the surgical management of a wide variety of cutaneous tumors. To our knowledge, this is the first time MMS has been used in the resection of a PEA.

Syringoid eccrine carcinoma is an extremely rare cutaneous malignant tumor, thought to be derived from eccrine sweat apparatus. We report a case of syringoid eccrine carcinoma occurring on the scalp of a 66-year-old woman and analyzed its cytokeratin expression immunohistochemically to clarify its histogenesis. The tumor consisted mainly of numerous small cords and nests extending from the reticular dermis to the subcutaneous tissue, which formed luminal or tubular structures mimicking the nests of syringoma. Immunohistochemical analysis revealed that most tumor cells expressed simple epithelial cytokeratins (CKs 7, 8, 18, 19) suggesting their sweat secretory differentiation, and that a small number of tumor cells showed an expression of stratified epithelial cytokeratins (CKs 5, 14) suggesting their ductal differentiation. We believe that the syringoid eccrine carcinoma of our case may differentiate mainly toward the sweat secretory cells rather than toward the dermal ductal cells.

Digital papillary adenocarcinoma is a rare tumour originating from sweat glands, often occurring in digits of the hand or foot. We present the case of a 52-year-old mechanic with this tumour at the distal phalanx of the middle finger. It was primarily excised. After histological verification of the diagnosis, amputation and axillary lymphadenectomy was performed. So far, no clinical or histological parameters were found to be predictive for recurrence or metastasis. This indicates that the originally proposed criteria for distinguishing between benign (adenoma) and malignant (adenocarcinoma) do not necessarily predict biologic behaviour. As according to the available literature metastases occurred in 14 % of the described patients within ten years, we propose an aggressive surgical approach consisting of amputation and regional lymph node dissection.

Purpose/methods: Ocular adnexal malignant tumors with eccrine differentiation represent a rare group of neoplasms with a great invasive capacity. Authors present clinical findings in an eighty five years old patient who developed a progressive painless induration of both eyelids in his right eye., Results/conclusions: Microscopic examination of biopsy specimen suggested a primary eccrine sweat glands carcinoma of the eyelids after a thorough search for tumors. We also describe the surgical technique used for this treatment, as well as the current supportive therapies for these kinds of tumors.

The sweat gland carcinoma is a rare tumor, representing in approximately 1% of primary skin lesions. In the literature 220 cases of sweat gland carcinomas have been presented over the last three decades. The medium age is 57 years, with an equal male-to-female distribution. Topographically, the tumor is located at the lower limbs (32.9%), the upper extremities (28%), and the head (26%). Involvement of the trunk is rare. Diagnosis can be complicated as the carcinoma is a rare entity, with no correlation of its histologic classification and biologic presentation. This can only implicate the difficulties in treatment.