Evaluation of Sentinel Lymph Node Biopsy for Eccrine Porocarcinoma

Tsunoda, Kenji; Onishi, Masazumi; Maeda, Fumihiko; Akasaka, Toshihide; Sugai, Tamotsu; Amano, Hodaka

doi:10.2340/00015555-3173

Cited by 13 publications

(23 citation statements)

References 14 publications

(17 reference statements)

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“…The positivity rate of SLN metastasis was found to be 37.5%, which is higher than that reported for malignant melanoma [ 56 , 57 ]. Based on these results and considering that the lymphatic route is thought to be the main initial metastatic pathway of EPCs, the authors suggested that the early detection of lymph node metastasis via SLN biopsy and subsequent lymph node dissection in positive cases could improve the overall survival of these patients [ 56 ]. However, in a SEER analysis of patients with adnexal carcinomas, SLN biopsy was only performed in 8.1% of patients, showing no significant difference in survival based on nodal status [ 51 ].…”

Section: Treatmentcontrasting

confidence: 59%

“…In 2019, Tsunoda et al conducted a study to specifically assess the utility of SLN biopsy in 13 patients with EPC. Among them, eight underwent SLN biopsy, with only one WLE due to low performance status and four received regional lymph node dissection due to clinical and/or radiological evidence of lymph node involvement [ 56 ]. The positivity rate of SLN metastasis was found to be 37.5%, which is higher than that reported for malignant melanoma [ 56 , 57 ].…”

Section: Treatmentmentioning

confidence: 99%

“…Among them, eight underwent SLN biopsy, with only one WLE due to low performance status and four received regional lymph node dissection due to clinical and/or radiological evidence of lymph node involvement [ 56 ]. The positivity rate of SLN metastasis was found to be 37.5%, which is higher than that reported for malignant melanoma [ 56 , 57 ]. Based on these results and considering that the lymphatic route is thought to be the main initial metastatic pathway of EPCs, the authors suggested that the early detection of lymph node metastasis via SLN biopsy and subsequent lymph node dissection in positive cases could improve the overall survival of these patients [ 56 ].…”

Section: Treatmentmentioning

confidence: 99%

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Eccrine Porocarcinoma: A Review of the Literature

et al. 2023

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Eccrine porocarcinoma (EPC) constitutes a rare malignant adnexal tumor, which accounts for about 0.005–0.01% of all cutaneous malignancies. It may develop de novo or arise from an eccrine poroma, after a latency period of years or even decades. Accumulating data suggest that specific oncogenic drivers and signaling pathways may be implicated in its tumorigenesis, while recent data have demonstrated a high overall mutation rate attributed to UV exposure. Diagnosis may be challenging and should rely on the combination of clinical, dermoscopical, histopathological and immunohistochemical findings. The literature is controversial regarding tumor behavior and prognosis and, therefore, there is no consensus on its surgical management, utility of lymph-node biopsy and further adjuvant or systemic treatment. However, recent advances in tumorigenesis of EPC may aid in the development of novel treatment strategies, which could improve survival of advanced or metastatic disease, such as immunotherapy. This review presents an update of the epidemiology, pathogenesis and clinical presentation of EPC and summarizes current data on diagnostic evaluation and management of this rare cutaneous malignancy.

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Section: Treatmentcontrasting

confidence: 59%

Section: Treatmentmentioning

confidence: 99%

Section: Treatmentmentioning

confidence: 99%

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Eccrine Porocarcinoma: A Review of the Literature

et al. 2023

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“…On the other hand, the role of sentinel lymph node sampling (SLNS), which has become a standard procedure in thick malignant melanomas, remains unclear for porocarcinoma. Because of the relatively high rates of lymphatic metastases with porocarcinoma, some authors propose that SLNS should be standardized in the first-line management for optimal staging and decisions on appropriate adjuvant treatments [15,16]. However, when a micrometastasis is detected in the sentinel lymph nodes the second step in treatment is not clear.…”

Section: Discussionmentioning

confidence: 99%

“…Although cutaneous adnexal tumors are considered relatively chemoresistant, there are case reports in the literature showing that satisfactory treatment results are obtained with single-agent or multi-agent systemic treatments, targeted therapies, or hormone therapy agents such as tamoxifen [19,20]. On the other hand, there are also centers where adjuvant chemotherapy after excision of the primary tumor, is the standard protocol in cases with lymph node metastasis and without distant metastasis [15]. Since our patient had only micrometastatic lymph nodes, adjuvant chemotherapy was not applied, and no distant or regional recurrence was observed at the end of the 24-month follow-up.…”

Section: Discussionmentioning

confidence: 99%

Adjuvant radiotherapy in the management of porocarcinoma with lymphatic micrometastasis

et al. 2023

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Background. Porocarcinoma is a rare skin tumor originating from dermal sweat glands. Surgical procedures are the first choice of treatment, but the role of adjuvant therapies, such as chemotherapy and radiotherapy (RT), is not clear. In this case report and review of the literature, we aimed to present a patient who underwent adjuvant RT for the diagnosis of porocarcinoma with lymphatic micrometastasis and a review of the current literature.Case summary. A 61-year-old male was admitted to the dermatology department for a nodular lesion on the left knee skin. An excisional biopsy was performed, and the pathology result was reported as porocarcinoma.The closest surgical margin of the tumor was 0.2 cm. In the inguinal sentinel lymph node sampling, two of the three removed lymph nodes had micrometastases. Then, adjuvant RT was applied to the left inguinofemoral lymphatics and primary tumor bed. No recurrence was observed in the patient with a follow-up period of 24 months.No acute or late toxicity was observed including lymphedema, subcutaneous fibrosis, or stiffness of the knee joint.Conclusions. Although adjuvant RT is not a routinely recommended treatment, it can be applied to increase local and regional control in patients with high-risk factors for recurrence or with lymph node metastases. There is a great need for clinical studies clarifying the role of RT, but for now, all patients should undergo multidisciplinary evaluation when a decision on adjuvant therapies is made.

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