Cho Woo Cheal, Wagner Brian, Gulosh Melissa, Elaba Zendee
1 Hartford Hospital, Hartford, CT, USA.
2 Connecticut Foot Specialist, Hartford, CT, USA.
Int J Surg Pathol. 2017 Oct;25(7):659-664. doi: 10.1177/1066896917712453. Epub 2017 May 29.
Syringoid eccrine carcinoma is a rare malignant adnexal tumor that typically presents in the head and neck region. Involvement of the extremities is uncommon, with only a few cases reported in the literature. Here, we report our experience with a rare case of syringoid eccrine carcinoma occurring on the plantar surface of the right foot in a 47-year-old African American woman. Histologically, incisional biopsy revealed a tumor consisting of tubulocystic structures lined by basaloid cells with an infiltrative growth pattern, extending from the reticular dermis to the deep biopsy margin. Some of the nests and cords of basaloid cells displayed syringoma-like, tadpole morphology. Immunohistochemical analysis showed diffuse immunoreactivity with monoclonal carcinoembryonic antigen, epithelial membrane antigen, cytokeratin 7, S100 protein, and CD117. These morphologic and immunophenotypic features were most consistent with syringoid eccrine carcinoma. Syringoid eccrine carcinoma has a broad differential diagnosis which must be carefully ruled out by morphology, immunohistochemistry, and thorough metastatic survey with imaging studies. Our case highlights the importance of recognizing this rare entity, which is locally destructive and has a propensity for recurrence. To the best of our knowledge, this is the first reported case of syringoid eccrine carcinoma presenting on the sole of the foot.
汗腺样小汗腺癌是一种罕见的恶性附属器肿瘤,通常发生于头颈部区域。累及四肢的情况并不常见,文献中仅有少数病例报道。在此,我们报告一例发生于一名47岁非裔美国女性右足底的罕见汗腺样小汗腺癌病例。组织学检查显示,切开活检发现肿瘤由基底样细胞衬里的管状囊性结构组成,呈浸润性生长模式,从网状真皮层延伸至深层活检边缘。一些基底样细胞巢和索呈现出汗腺腺瘤样的蝌蚪形态。免疫组化分析显示,肿瘤弥漫性表达单克隆癌胚抗原、上皮膜抗原、细胞角蛋白7、S100蛋白和CD117。这些形态学和免疫表型特征与汗腺样小汗腺癌最为相符。汗腺样小汗腺癌的鉴别诊断范围广泛,必须通过形态学、免疫组化以及影像学检查进行全面的转移评估来仔细排除。我们的病例突出了认识这种罕见疾病的重要性,它具有局部破坏性且易于复发。据我们所知,这是首例报道的发生于足底的汗腺样小汗腺癌病例。