Bottles K, Sagebiel R W, McNutt N S, Jensen B, Deveney K
Cancer. 1984 Apr 1;53(7):1579-85. doi: 10.1002/1097-0142(19840401)53:7<1579::aid-cncr2820530726>3.0.co;2-u.
A case of malignant eccrine poroma with lymph node metastases is described. The patient had a nodular growth of the right thigh 2 years before its first excision. Local recurrence in the scar occurred in 6 months, and by 8 months a right groin lymph node was involved. Subsequent skin nodules of the right thigh occurred over the next 12 months, associated with recurrent lymphedema of the leg. During several follow-up visits, associated malignancies were found including villous adenoma of the ascending colon and renal cell carcinoma of the right kidney, both typical histologically and unrelated to the cutaneous tumor. Subsequently, left inguinal lymph node disease histologically identical to the skin tumor was found. Clinical and histologic findings were similar to the 31 previous cases reviewed. Electron microscopic examination confirmed the presence of a ductal structure consistent with eccrine duct and a crystalline membrane-bound granule which may represent a specific marker for this rare tumor. The histologic features of this tumor are important to separate from other differential diagnostic possibilities which may have a quite different prognosis.
本文描述了一例伴有淋巴结转移的恶性小汗腺汗孔瘤。患者首次切除肿物前2年，右大腿出现结节状肿物。6个月后瘢痕处出现局部复发，8个月时右侧腹股沟淋巴结受累。在接下来的12个月里，右大腿出现了后续的皮肤结节，并伴有腿部反复出现的淋巴水肿。在几次随访中，发现了相关的恶性肿瘤，包括升结肠绒毛状腺瘤和右肾肾细胞癌，两者在组织学上均典型，且与皮肤肿瘤无关。随后，发现左侧腹股沟淋巴结病变在组织学上与皮肤肿瘤相同。临床和组织学表现与之前回顾的31例病例相似。电子显微镜检查证实存在与小汗腺导管一致的导管结构以及一种晶体膜结合颗粒，这可能是这种罕见肿瘤的特异性标志物。该肿瘤的组织学特征对于与其他可能具有完全不同预后的鉴别诊断可能性相区分很重要。
