Saraiva Maria Isabel Ramos, Vieira Marcella Amaral Horta Barbosa, Portocarrero Larissa Karine Leite, Fraga Rafael Cavanellas, Kakizaki Priscila, Valente Neusa Yuriko Sakai
Universidade de São Paulo (USP) - São Paulo (SP), Brazil.
Private Clinic - Juiz de Fora (MG), Brazil.
An Bras Dermatol. 2016 Nov-Dec;91(6):799-802. doi: 10.1590/abd1806-4841.20164682.
Squamoid eccrine ductal carcinoma is an eccrine carcinoma subtype, and only twelve cases have been reported until now. It is a rare tumor and its histopathological diagnosis is difficult. Almost half of patients are misdiagnosed as squamous cell carcinoma by the incisional biopsy. We report the thirteenth case of squamoid eccrine ductal carcinoma. Female patient, 72 years old, in the last 6 months presenting erythematous, keratotic and ulcerated papules on the nose. The incisional biopsy diagnosed squamoid eccrine ductal carcinoma. After excision, histopathology revealed positive margins. A wideningmargins surgery and grafting were performed, which again resulted in positive margins. The patient was then referred for radiotherapy. After 25 sessions, the injury reappeared. After another surgery, although the intraoperative biopsy showed free surgical margins, the product of resection revealed persistent lesion. Distinction between squamoid eccrine ductal carcinoma and squamous cell carcinoma is important because of the more aggressive nature of the first, which requires wider margins surgery to avoid recurrence.
鳞状小汗腺导管癌是小汗腺癌的一种亚型，截至目前仅有12例病例报告。它是一种罕见肿瘤，其组织病理学诊断困难。几乎一半的患者在切开活检时被误诊为鳞状细胞癌。我们报告第13例鳞状小汗腺导管癌。72岁女性患者，在过去6个月里鼻子上出现红斑、角化和溃疡丘疹。切开活检诊断为鳞状小汗腺导管癌。切除术后，组织病理学显示切缘阳性。进行了扩大切缘手术和植皮，但再次出现切缘阳性。然后患者接受放疗。25次放疗后，损伤再次出现。再次手术后，尽管术中活检显示手术切缘阴性，但切除产物显示病变持续存在。区分鳞状小汗腺导管癌和鳞状细胞癌很重要，因为前者侵袭性更强，需要更宽切缘的手术以避免复发。
