Eccrine porocarcinoma of the head and neck: Meta‐analysis of 120 cases

Abstract

Background The aim of the study is to analyze potential prognostic factors and to evaluate therapy strategies regarding clinical outcome in patients with eccrine porocarcinoma (EPC) of the head and neck. Methods One hundred and sixteen EPC cases from ninety studies and four authors' EPC cases were included in the meta‐analysis. Results At an average follow up of 20.48 months, the 3‐year overall survival and regional recurrence rate were 70.3% and 19.0%, respectively. Patients without surgical treatment had a significantly worse 3‐year overall survival. Mohs microscopic surgery led to significantly less occurrence of regional recurrences compared to wide excision. An ulcerating lesion, high mitotic activity, and lymphovascular invasion were significant prognostic factors. Conclusion Surgical resection is the cornerstone in the therapy of EPC and represents the therapeutic modality that offers the best chance of disease‐free survival. Due to the high probability of recurrence, close follow‐ups are strongly recommended.

Eccrine Porocarcinoma: Avoiding Diagnostic Delay

“…A recent review found that in total of 92 surgically treated cases, WLE (76.7%) was most commonly performed compared with MMS (15.8%). 13 However, a smaller review of 28 cases, writes that metastasis after WLE was much higher at 61% versus only 3.6% after MMS. 4 One case reported success with WLE and adjunctive chemotherapy for lymph node metastasis.…”

“…20 However, adjunctive treatment therapies, such as chemotherapy and radiotherapy, have been reviewed and these did not significantly improve prognosis. 13…”

“…12 A recent meta-analysis of 120 cases suggests that the lesions most commonly arise in the head and neck (39.9%), followed by lower extremities (33.9%), and then the trunk (12.3%) and upper extremity (8.8%). 13 When attempt is made at local excision roughly 20% reoccur and the frequency of metastasis is approximately 22%, with regional lymph node involvement most common. 4,8,14-17 Since diagnosis is rare and the outcomes can be devastating to a patient, the authors present a case study to increase awareness of EPC.…”

Current Diagnosis and Treatment Options for Cutaneous Adnexal Neoplasms with Apocrine and Eccrine Differentiation

“…However, great responses are not usually seen in the reported cases, and only in a few of them was a beneficial effect obtained, for example, the combination of chemotherapy (cisplatin/docetaxel) and radiation (50 Gy/25 fractions) in a patient with metastatic disease resulted in complete response [ 11 , 58 , 59 ]. De Bree et al successfully applied extensive cutaneous metastases with topical 5-fluorouracil combined with intraarterial docetaxel [ 60 ]. Complete rehabilitation in a case with multiple skin metastases under hyperthermic perfusion with the administration of melphalan and intra-arterial 5-fluorouracil was reported by Briscoe et al [ 61 ].…”

Metastatic Porocarcinoma Effectively Managed by Pembrolizumab

“…Eccrine porocarcinoma (EPC), or malignant eccrine poroma, is a rare skin cancer of the cutaneous intraepidermal ducts of sweat glands. Porocarcinoma accounts for less than 0.01% of all cutaneous malignancies, and it is generally seen in adults aged 50 to 80 with conflicting information regarding gender predominance [ 1 , 2 ]. Reports show that EPC can develop de novo or originate from a pre-existing eccrine poroma, a benign growth of the sweat glands.…”