Dermoscopy of squamoid eccrine ductal carcinoma: an aid for early diagnosis

Lobo-Jardim, Márcio Martins; Souza, Bruno de Castro e; Kakizaki, Priscila; Valente, Neusa Yuriko Sakai

doi:10.1590/abd1806-4841.20187307

Cited by 2 publications

(2 citation statements)

References 5 publications

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“…Our review yielded 56 cases of SEDC. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19] The mean age of patients with SEDC was 72 years. The number of male and female cases was 52% (29/56) and 48% (27/56), respectively.…”

Section: Literature Reviewmentioning

confidence: 99%

Squamoid Eccrine Ductal Carcinoma

Svoboda¹,

Rush²,

Garofola³

et al. 2021

Cutis

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Squamoid eccrine ductal carcinoma (SEDC) is a rare and underrecognized primary cutaneous tumor with a high risk for local recurrence and metastasis. The tumor has a biphasic histologic appearance consisting of a superficial portion indistinguishable from squamous cell carcinoma (SCC) and a deeper component demonstrating eccrine ductal differentiation. Because of superficial sampling, SEDC often is misdiagnosed as SCC during the initial biopsy. The diagnosis usually is made during complete excision when deeper tissue is sampled. Confirmation of the diagnosis can be achieved by immunohistochemical positivity for carcinoembryonic antigen (CEA), epithelial membrane antigen (EMA), cytokeratin (CK) 5/6, and p63. In this article, we review the clinical and histologic details of 5 patients with SEDC who underwent successful treatment with Mohs micrographic surgery (MMS) at a single institution between November 2018 and May 2020. We also review the histologic patterns that helped distinguish SEDC from SCC upon complete excision. Our findings support the use of MMS as the treatment of choice for SEDC, given that all of the patients we reviewed required more than 1 Mohs stage for complete tumor clearance, and none demonstrated evidence of recurrence or metastasis after a mean follow-up period of 11 months.Cutis. 2021;107:E5-E9. Squamoid eccrine ductal carcinoma (SEDC) is an aggressive underrecognized cutaneous malignancy of unknown etiology. 1 It is most likely to occur in sun-exposed areas of the body, most commonly the head and neck. Risk factors include male sex, increased age, and chronic immunosuppression. [1][2][3][4] Current reports suggest that SEDC is likely a high-grade subtype of squamous cell carcinoma (SCC) with a high risk for local recurrence (25%) and metastasis (13%). 1,3,5,6 There are as few as 56 cases of SEDC reported in the literature; however, the number of cases may be closer to 100 due to SEDC being classified as either adenosquamous carcinoma of the skin or ductal eccrine carcinoma with squamous differentiation. 1 Clinically, SEDC mimics keratinocyte carcinomas. Histologically, SEDC is biphasic, with a superficial portion resembling well-differentiated SCC and a deeply invasive portion having infiltrative irregular cords with ductal differentiation. Perineural invasion (PNI) frequently is present. Multiple connections to the overlying epidermis also can be seen, serving as a subtle clue to the diagnosis on broad superficial specimens. [1][2][3] Due to superficial sampling, approximately 50% of reported cases are misdiagnosed as SCC during the initial biopsy. 4 The diagnosis of SEDC often is made during complete excision when deeper tissue is sampled. Establishing an accurate diagnosis is important given the more aggressive nature of SEDC compared with SCC and its proclivity for PNI. 1,3,6 The purpose of this review is to increase awareness of this underrecognized entity and describe the histologic findings that help distinguish SEDC from SCC.

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Section: Literature Reviewmentioning

confidence: 99%

Squamoid Eccrine Ductal Carcinoma

Svoboda¹,

Rush²,

Garofola³

et al. 2021

Cutis

View full text Add to dashboard Cite

show abstract

“…Squamoid eccrine ductal carcinoma's low prevalence and non-specific clinical features that overlap with those of more common cutaneous malignancies could result in diagnostic delay. As dermoscopic findings have rarely been reported and vary, their utility in the diagnosis is not yet known[5,6]. There are no established risk factors, although rare cases in the setting of immunosuppression related to organ transplantation or leukemia have been reported[7].…”

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confidence: 99%