BackgroundSweat gland adenocarcinoma is a rare malignancy with high metastatic potential seen more commonly in later years of life. Scalp is the most common site of occurrence and it usually spreads to lymph nodes. Liver, lung and bones are the distant sites of metastasis with fatal results. The differentiation between apocrine and eccrine metastatic sweat gland carcinoma is often difficult. The criteria's are inadequate to be of any practical utility.Case ReportTwo cases of metastatic sweat gland adenocarcinoma (one of eccrine and the other one of apocrine origin) are being reported on account of the rarity and different outcome.ConclusionSweat gland carcinomas are rare cancers with a poor prognosis often presenting as histological surprises. Surgery in the form of wide local excision and lymph node dissection is the mainstay of treatment. Chemotherapy and/or radiotherapy has limited role.
BackgroundRadiotherapy in the radical doses can produce severe and often irreversible damage to the gut in the form of fibrosis, necrosis and fistulae formation. A previous pelvic surgery makes the gut extra-vulnerable. This is on account of adhesions to the pelvic wall, unless special care is taken during surgery to keep it out of the harms way, during adjuvant radiotherapy. These effects range from acute, to sub acute and delayed chronic manifestations like in the reported case.Case reportA spontaneous low out put enterocutaneous fistula in a 68-year-old man following surgery and adjuvant radiotherapy given 27 years back for carcinoma penis is reported. Patient is making a satisfactory progress after three years of follow-up.ConclusionHigh dose external beam radiotherapy is known to produce deleterious side effects ranging from mild radiation enteritis to the development of internal and external fistulae. The effects may be acute, subacute or chronic. Presentation as spontaneous enterocutaneous fistula 27 years after radiotherapy is rare.
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