Javadirad Etrat, Azimivaghar Javad, Montazer Saba
Department of Pathology, School of Medicene, Kermanshah University of Medical Sciences, Kermanshah, Iran.
Department of Cardiology, School of Medicene, Kermanshah University of Medical Sciences, Kermanshah, Iran.
Caspian J Intern Med. 2020 May;11(3):337-339. doi: 10.22088/cjim.11.3.337.
Primary mucinous eccrine carcinoma (PMEC) is a quite rare malignant tumor that typically involves the head and neck region in approximately 75% of patients and the periorbital area is the most common area.
A 57-year-old man was seen with a painless red mass involving the left lower eyelid for the past 7 months. Examination revealed a small mass measuring 0.6 cm with shiny red smooth appearance of the skin. H&E stained examination revealed a tumor mass that composed of polygonal cells in nests, lobules and islands separated by large amount of mucin. The neoplastic cells showed eosinophilic cytoplasm and round nuclei with mild pleomorphism. There was no necrosis, no atypical mitosis, no lymphovascular and perineural invasion. Rare mitotic figures were found. Tumoral nests present on all surgical margins. Primary MEC is a slow-growing neoplasm that may recur after incomplete surgical excision. This tumor is often clinically mistaken for other cutaneous tumors due to its variable appearance. Recurrent tumor tends to be locally invasive with a rare metastatic rate of 9.6%.
As a result of the recurrence risk, patients should be followed up regularly. Thus, our patient was recommended to have a regular follow-up every six months.
原发性黏液性小汗腺癌(PMEC)是一种非常罕见的恶性肿瘤,约75%的患者肿瘤主要累及头颈部区域,其中眶周区域是最常见的部位。
一名57岁男性患者,在过去7个月里,左眼下睑出现无痛性红色肿物。检查发现一个0.6厘米的小肿物,皮肤表面呈亮红色且光滑。苏木精-伊红(H&E)染色检查显示肿瘤团块由多边形细胞构成,呈巢状、小叶状和岛状分布,其间有大量黏液。肿瘤细胞胞质嗜酸性,细胞核圆形,有轻度异型性。未见坏死、非典型性有丝分裂,无淋巴管和神经侵犯。仅见罕见的有丝分裂象。手术切缘均有肿瘤巢。原发性小汗腺癌是一种生长缓慢的肿瘤,手术切除不完全可能复发。由于其外观多变,该肿瘤在临床上常被误诊为其他皮肤肿瘤。复发性肿瘤往往具有局部侵袭性,转移率很低,为9.6%。
鉴于存在复发风险,患者应定期随访。因此,建议我们的患者每六个月进行一次定期随访。