Aniţei Gabriela Maria, Ioanid Nicolae Şerban, Bandol Geanina, Gafton Elena Rodica, Patraşcu Ana Maria, Ferariu Dan, Slătineanu Angelica, Bugean Gema, Scripcariu Viorel
"Grigore T. Popa" University of Medicine and Pharmacy, Iasi, Romania.
1 Surgical Oncology Unit, Regional Institute of Oncology, Iasi, Romania.
Arch Clin Cases. 2021 Oct 27;6(2):53-58. doi: 10.22551/2019.23.0602.10154. eCollection 2019.
Porocarcinoma is a rare tumor of the eccrine sweat glands that usually disseminates to the regional lymph nodes, but it can also develop distant metastasis. Case presentation: We report the case of a 67 year-old female patient who underwent wide surgical resection of a left cervical cutaneous tumor in a primary care center, for which the histology exam of the specimen was mixed basal cell and squamous cell carcinoma. She was referred to our hospital's oncology clinic and histologic re-evaluation changed the diagnosis to eccrine porocarcinoma (EPC). Computer-tomography (CT) revealed cervical lymphadenopathies for which the patient underwent 4 cycles of chemotherapy, without regression. She subsequently underwent a left upper anterior jugular lymphadenectomy (group IIa) with all nodes being negative and, three months later, she developed a unique adenopathy under the parotid gland that was excised and confirmed to be metastatic. Postoperative external radiotherapy was administered with a good outcome on CT scan. Nine months after her last surgery, the patient did not show any sign of recurrence or distant metastasis. Conclusion: EPC is a challenge, both diagnostically and therapeutically. In the absence of consensus regarding the indications and extent of lymphadenectomy and adjuvant therapy, patients with EPC should be referred to an experienced multidisciplinary team in a tertiary center.
汗孔癌是一种罕见的小汗腺肿瘤,通常会扩散至区域淋巴结,但也可发生远处转移。病例报告:我们报告一例67岁女性患者,其在基层医疗中心接受了左侧颈部皮肤肿瘤的广泛手术切除,标本的组织学检查显示为基底细胞癌和鳞状细胞癌混合。她被转诊至我院肿瘤门诊,组织学重新评估后诊断为汗孔癌(EPC)。计算机断层扫描(CT)显示颈部淋巴结肿大,患者接受了4个周期的化疗,但无缓解。随后她接受了左上前颈淋巴结清扫术(IIa组),所有淋巴结均为阴性,3个月后,她在腮腺下方出现了一个孤立的肿大淋巴结,切除后证实为转移性。术后进行了外照射放疗,CT扫描显示效果良好。最后一次手术后9个月,患者未出现任何复发或远处转移迹象。结论:EPC在诊断和治疗方面都是一个挑战。在淋巴结清扫术和辅助治疗的适应证和范围方面缺乏共识的情况下,EPC患者应转诊至三级中心经验丰富的多学科团队。