RESUMEN
Abstract Eccrine poroma and poroid hidradenoma are uncommon benign poroid neoplasms derived from eccrine sweat glands. There are four types of poroid neoplasms according to the position within the skin layer: hidroacanthoma simplex, eccrine poroma, dermal duct tumor, and poroid hidradenoma. Poroid neoplasms usually arise as slow-growing solitary lesions and can present different clinical presentations, such as a foot mass, an ulceration lesion, a solid cyst, a bleeding lesion or suspected melanoma. Extremities are the most common sites, especially hands and feet. However, the coexistence of these two tumors in a single lesion is extremely rare. Surgical excision represents the main treatment and can be curative, preventing malignant changes and recurrence. We describe a rare solitary tumor over the foot with clinical and histopathological features of an association of an eccrine poroma and a poroid hidradenoma that was surgically treated with no recurrence at the midterm follow-up. Level of EvidenceIV, Case Report.
Resumo O poroma écrino e o hidradenoma poroide são neoplasias poroides benignas raras, derivadas das glândulas sudoríparas écrinas. Existem quatro tipos de neoplasias poroides, conforme a posição na camada da pele, sendo denominadas hidroacantoma simples, poroma écrino, tumor do ducto dérmico e hidradenoma poroide. As neoplasias poroides geralmente surgem como uma lesão solitária, com crescimento lento, podendo apresentar diferentes apresentações clínicas, como massa sobre o pé, lesão ulcerada, cisto sólido, lesão hemorrágica ou suspeita de melanoma. As extremidades são os sítios mais comuns, especialmente as mãos e os pés. No entanto, a coexistência desses dois tumores em uma única lesão é extremamente rara. A excisão cirúrgica representa o principal tratamento, podendo ser curativa, prevenindo assim as alterações malignas e as recidivas. Descrevemos um raro tumor solitário no pé com características clínicas e histopatológicas de uma associação de poroma écrino e hidradenoma poroide tratado cirurgicamente sem recidiva no acompanhamento de médio prazo. Nível de EvidênciaIV, Relato de Caso.
Asunto(s)
Humanos , Masculino , Persona de Mediana Edad , Acrospiroma/diagnóstico , Acrospiroma/terapia , Poroma , Pie , NeoplasiasAsunto(s)
Poroma , Neoplasias de las Glándulas Sudoríparas , Humanos , Poroma/diagnóstico por imagen , Poroma/cirugía , Imagenología Tridimensional , Diagnóstico Diferencial , Neoplasias de las Glándulas Sudoríparas/diagnóstico por imagen , Neoplasias de las Glándulas Sudoríparas/cirugía , Microscopía ConfocalRESUMEN
Eccrine poroma is the term that includes benign neoplasms of the terminal duct of the eccrine sweat glands, which may clinically and dermoscopically resemble other melanoma and non-melanoma skin tumors. They are often located on the extremities (especially palms and soles), presenting as normochromic or erythematous papules and nodules, measuring up to 2 cm. Pigmented variants are uncommon, accounting for less than 20% of cases. This report describes a 37-year-old man who developed a large pigmented eccrine poroma on his right shoulder, causing diagnostic difficulty. Histopathological examination revealed a nodular neoplasm consisting of small, monomorphic, cuboidal cells, with ample, eosinophilic cytoplasm and well-defined borders, in addition to conspicuous intercellular bridges, with melanin deposits diffusely distributed inside them. The absence of cytological atypia, cellular pleomorphism, increased mitotic activity, and necrosis foci corroborated the diagnostic exclusion of porocarcinoma, which can develop from eccrine poroma.
Asunto(s)
Porocarcinoma Ecrino , Poroma , Neoplasias Cutáneas , Neoplasias de las Glándulas Sudoríparas , Adulto , Diagnóstico Diferencial , Humanos , MasculinoRESUMEN
Los poromas ecrinos son tumores anexiales benignos que se originan de la porción intraepidérmica del conducto de la glándula sudorípara, representan aproximadamente el 10 por ciento de todos los tumores de estas glándulas. La variante clásica de poroma se caracteriza por una neoformación de aspecto papular de color piel eritematosa, con predilección por las palmas y plantas. Presentamos el caso de una paciente femenina de 53 años de edad, con antecedentes de diabetes mellitus tipo I que acude a consulta de dermatología del policlínico de su área de salud, por presentar lesión en planta del pie izquierdo de 2 años de evolución, asintomática que comenzó como una bolita, notando que aumentaba de tamaño, acude primeramente a la consulta de podología y la envían a nuestra especialidad, donde es evaluada y se diagnóstica clínicamente un poroma ecrino. En el estudio histopatológico fue de gran valor en función de la orientación diagnóstica y se precisó la presencia de esta entidad. El caso presentado contribuye a visibilizar la necesaria revisión del tema teniendo en cuenta que representa un reto diagnóstico, por su gran variedad morfológica y se hacen necesarios los estudios histológicos(AU)
Eccrine poromas are benign adnexal tumors that originate from the intraepidermal portion of the sweat gland duct, representing approximately 10 percent of all tumors of these glands. The classic variant of poroma is characterized by a skin-colored or erythematous papular-looking neoformation, with a predilection for the palms and soles. We present the case of a 53-year-old female patient with a history of type I diabetes mellitus who attended the dermatology clinic of the polyclinic in her health area due to a 2-year history of an asymptomatic lesion on the sole of her left foot. It started as a small ball, noticing that it was increasing in size, she first went to the podiatry consultation and was sent to our specialty, where she was evaluated and an eccrine poroma was clinically diagnosed. In the histopathological study it was of great value depending on the diagnostic orientation and the presence of this entity was specified. The case presented contributes to make visible the necessary review of the subject, taking into account that it represents a diagnostic challenge, due to its great morphological variety and histological studies are necessary(EU)
Asunto(s)
Humanos , Femenino , Persona de Mediana Edad , Poroma/cirugía , Enfermedades Raras , Dermatosis del PieAsunto(s)
Epidermólisis Ampollosa Distrófica , Epidermólisis Ampollosa , Poroma , Neoplasias de las Glándulas Sudoríparas , Epidermólisis Ampollosa/genética , Epidermólisis Ampollosa Distrófica/complicaciones , Epidermólisis Ampollosa Distrófica/genética , Genes Recesivos , Humanos , Piel , Neoplasias de las Glándulas Sudoríparas/complicaciones , Neoplasias de las Glándulas Sudoríparas/diagnósticoAsunto(s)
Humanos , Neoplasias de las Glándulas Sudoríparas , Fibroadenoma , Poroma , Glándulas EcrinasAsunto(s)
Fibroadenoma , Poroma , Neoplasias de las Glándulas Sudoríparas , Glándulas Ecrinas , HumanosRESUMEN
Eccrine porocarcinoma (EPC) is a rare malignant skin tumor. The dermoscopy of invasive EPC reveals focal presence of whitish-pink, structureless areas surrounded by pinkish-white halos. In an eccrine poroma (EP), such areas present diffuse distribution in the "frog- eggs" pattern. We reported an EPC in situ that presents a transitional dermoscopy pattern between EP and invasive EPC. We found a diffuse distribution; whitish-pink, structureless areas surrounded by pinkish-white halos; a central exulceration and a polymorphic vascular pattern.
Asunto(s)
Porocarcinoma Ecrino/diagnóstico por imagen , Poroma/diagnóstico por imagen , Neoplasias de las Glándulas Sudoríparas/diagnóstico por imagen , Anciano , Biopsia , Dermoscopía/métodos , Diagnóstico Diferencial , Porocarcinoma Ecrino/patología , Femenino , Humanos , Pierna , Poroma/patología , Neoplasias de las Glándulas Sudoríparas/patologíaRESUMEN
Abstract Eccrine porocarcinoma (EPC) is a rare malignant skin tumor. The dermoscopy of invasive EPC reveals focal presence of whitish-pink, structureless areas surrounded by pinkish-white halos. In an eccrine poroma (EP), such areas present diffuse distribution in the "frog- eggs" pattern. We reported an EPC in situ that presents a transitional dermoscopy pattern between EP and invasive EPC. We found a diffuse distribution; whitish-pink, structureless areas surrounded by pinkish-white halos; a central exulceration and a polymorphic vascular pattern.
Asunto(s)
Humanos , Femenino , Anciano , Neoplasias de las Glándulas Sudoríparas/diagnóstico por imagen , Poroma/diagnóstico por imagen , Porocarcinoma Ecrino/diagnóstico por imagen , Neoplasias de las Glándulas Sudoríparas/patología , Biopsia , Dermoscopía/métodos , Diagnóstico Diferencial , Poroma/patología , Porocarcinoma Ecrino/patología , PiernaRESUMEN
El poroma es un tumor benigno infrecuente derivado de la porción intraepitelial del epitelio ductal de la glándula sudorípara. La presentación clínica más habitual es un pápula o nódulo de color rosado a rojo, de pequeño diámetro, localizado con mayor frecuencia en palmas y plantas, generalmente asintomático. Debido a su variabilidad morfológica, los poromas son usualmente difíciles de reconocer, siendo la dermatoscopía una herramienta útil en su diagnóstico. Presentamos el caso de un paciente masculino con un gran tumor en su pierna derecha de 40 mm de diámetro, con características dermatoscópicas compatibles con poroma no pigmentado. El diagnóstico confirmatorio se realizó con una biopsia incisional seguido de la extirpación quirúrgica completa del tumor
Poroma is a rare benign tumour derived from the intraepithelial portion of the sweat glands' ductal epithelium. The most common clinical presentation is a pink to red papule or nodule, small in diameter, predominantly in the palms and soles and generally asymptomatic. Due to its morphologic variability, poromas are usually difficult to recognize, thus dermatoscopy becomes a useful aid in its diagnosis. We present the case of a male patient with a large tumour on his right leg, 40 mm in diameter, with dermatoscopic features consistent with nonpigmented poroma. Confirmatory diagnosis was made by incisional biopsy followed by the total surgical excision of the tumor.
Asunto(s)
Humanos , Masculino , Persona de Mediana Edad , Neoplasias de las Glándulas Sudoríparas/diagnóstico , Dermoscopía/métodos , Poroma/diagnóstico , Neoplasias de las Glándulas Sudoríparas/patología , Diagnóstico Diferencial , Poroma/patologíaRESUMEN
Abstract: Poroid neoplasms are benign epithelial proliferations with eccrine sweat gland differentiation. They are a challenging diagnosis because of the clinical heterogeneity, being able to mimic several malignant neoplasms. They are classified into classic poroma, hidroacanthoma simplex, dermal duct tumor and poroid hidradenoma. Association of histological subtypes occurs in more than 25% of cases. We report a case of a combined poroid neoplasia of classical poroma and poroid hidradenoma, reviewing its dermatoscopic features.
Asunto(s)
Humanos , Femenino , Anciano , Neoplasias de las Glándulas Sudoríparas/patología , Neoplasias de las Glándulas Sudoríparas/diagnóstico por imagen , Poroma/patología , Poroma/diagnóstico por imagen , DermoscopíaRESUMEN
Poroid neoplasms are benign epithelial proliferations with eccrine sweat gland differentiation. They are a challenging diagnosis because of the clinical heterogeneity, being able to mimic several malignant neoplasms. They are classified into classic poroma, hidroacanthoma simplex, dermal duct tumor and poroid hidradenoma. Association of histological subtypes occurs in more than 25% of cases. We report a case of a combined poroid neoplasia of classical poroma and poroid hidradenoma, reviewing its dermatoscopic features.
Asunto(s)
Poroma/diagnóstico por imagen , Poroma/patología , Neoplasias de las Glándulas Sudoríparas/diagnóstico por imagen , Neoplasias de las Glándulas Sudoríparas/patología , Anciano , Dermoscopía , Femenino , HumanosRESUMEN
Eccrine poromas and porocarcinomas are adnexal tumors derived from the sweat duct epithelium. However, eccrine poroma is benign in nature, whilst eccrine porocarcinoma is regarded as its malignant counterpart. We report the case of a man who presented simultaneously with an eccrine poroma and eccrine porocarcinoma. Both lesions had no clear distinctive features, enhancing the need of high-level clinical suspicion together with surgical excision and histopathology for prompt diagnosis confirmation.
Asunto(s)
Porocarcinoma Ecrino/patología , Neoplasias Primarias Múltiples/patología , Poroma/patología , Neoplasias de las Glándulas Sudoríparas/patología , Anciano , Biopsia , Diagnóstico Diferencial , Porocarcinoma Ecrino/diagnóstico , Humanos , Masculino , Neoplasias Primarias Múltiples/diagnóstico , Poroma/diagnóstico , Neoplasias de las Glándulas Sudoríparas/diagnósticoRESUMEN
Abstract: Eccrine poromas and porocarcinomas are adnexal tumors derived from the sweat duct epithelium. However, eccrine poroma is benign in nature, whilst eccrine porocarcinoma is regarded as its malignant counterpart. We report the case of a man who presented simultaneously with an eccrine poroma and eccrine porocarcinoma. Both lesions had no clear distinctive features, enhancing the need of high-level clinical suspicion together with surgical excision and histopathology for prompt diagnosis confirmation.
Asunto(s)
Humanos , Masculino , Anciano , Neoplasias de las Glándulas Sudoríparas/patología , Poroma/patología , Porocarcinoma Ecrino/patología , Neoplasias Primarias Múltiples/patología , Neoplasias de las Glándulas Sudoríparas/diagnóstico , Biopsia , Diagnóstico Diferencial , Poroma/diagnóstico , Porocarcinoma Ecrino/diagnóstico , Neoplasias Primarias Múltiples/diagnósticoRESUMEN
Hidroacanthoma simplex is a rare intraepidermal neoplasia that arises from the acrosyringial portion of the eccrine duct. Malignant transformation of hidroacanthoma simplex is reported in the literature and the treatment is performed with wide excision or Mohs micrographic surgery. We report the first case successfully treated with cryosurgery with a long-term follow up.
Asunto(s)
Criocirugía , Porocarcinoma Ecrino/cirugía , Poroma/cirugía , Neoplasias de las Glándulas Sudoríparas/cirugía , Anciano , Dermoscopía , Porocarcinoma Ecrino/patología , Humanos , Masculino , Poroma/patología , Neoplasias de las Glándulas Sudoríparas/patologíaRESUMEN
Abstract: Hidroacanthoma simplex is a rare intraepidermal neoplasia that arises from the acrosyringial portion of the eccrine duct. Malignant transformation of hidroacanthoma simplex is reported in the literature and the treatment is performed with wide excision or Mohs micrographic surgery. We report the first case successfully treated with cryosurgery with a long-term follow up.
Asunto(s)
Humanos , Masculino , Anciano , Neoplasias de las Glándulas Sudoríparas/cirugía , Criocirugía , Poroma/cirugía , Porocarcinoma Ecrino/cirugía , Neoplasias de las Glándulas Sudoríparas/patología , Dermoscopía , Poroma/patología , Porocarcinoma Ecrino/patologíaRESUMEN
Resumen:El porocarcinoma ecrino es un tipo muy poco frecuente de cáncer de piel, originado en la porción epidérmica de las glándulas sudoríparas ecrinas. Representa no más del 0.01% de los tumores cutáneos. El 20% de los porocarcinomas ecrinos son recurrentes y el 20% producen metástasis a ganglios linfáticos. Se ha reportado escasos casos de metástasis a distancia. Tiene un índice de mortalidad del 67% de los pacientes con metástasis.El diagnóstico es basado en los hallazgos histopatológicos y los estudios complementarios de inmunohistoquímica, a veces necesarios para el diagnóstico diferencial con otros tipos más frecuentes de cáncer de piel.No existen pruebas de que este tipo de carcinoma responda a la quimioterapia ni la radioterapia. Se considera que el manejo principal debe ser la resección quirúrgica y la electroquimioterapia.
Abstract:Eccrine porocarcinoma is a rare type of skin cáncer arising from the intraepidermal portion of eccrine sweat glands, representing no more tan 0.01% of all cutaneous tumors. 20% of the Eccrine porocarcinoma will recur and 20% will metastasize to regional lymph nodes. Few cases of distant metastases has been reported . There is a mortality rate of 67% in patients with metastases. The diagnosis is primarily based on histopathologic findings and complementary immunohistochemistry for differential diagnosis mainly with more frequent skin cáncer.Neither chemotherapy nor radiation therapy has been proven to be of clinical benefit in treating this type of carcinoma. It is considered that the management should be based on surgical resection and electrochemotherapy.
Asunto(s)
Humanos , Neoplasias de las Glándulas Sudoríparas , Glándulas Sudoríparas , Poroma , Porocarcinoma EcrinoRESUMEN
El poroma ecrino (PE) corresponde a una neoplasia anexial benigna originada de la porción intraepidérmica del conducto de las glándulas sudoríparas. Habitualmente se describe como nódulos eritematosos o color piel ubicados en región palmoplantar, pero sus características clínicas son muy variables. Se decriben los hallazgos clínicos y dermatoscópicos de una serie de casos de pacientes con PE. La dermatoscopia puede facilitar significativamente el diagnóstico clínico de la mayoría de los tumores de la piel, sin embargo el PE se caracteriza por un alto grado de variabilidad a la dermatoscopía. Habitualmente se describe un patrón vascula polimorfo con vasos glomerulares, en horquilla, y lineales irregulares con terminaciones semicirculares rodeados de un halo blanco a rosa en forma de caliz o flor de cerezo asociado a áreas rosadas blanquecinas sin estructuras similares a lo observado en melanoma amelanótico, carcinoma espinocelular entre otros tumores benignos y malignos. El PE puede exhibir características clínicas y dermatoscópicas polimórficas que pueden hacer difícil el diagnóstico y su diferenciación de otras neoplasias cutáneas.
Eccrine poroma (PE) is a benign adnexal neoplasm of the intraepidermal portion of the sweat gland duct. PE typically present as erythematous or flesh-colored nodules on the palms and soles, but the clinical features of PE are highly variable. Dermatoscopic and clinical findings of patients with EP are described. Dermoscopy may significantly improves the clinical diagnosis of most skin tumours, but PE is characterised by a high degree of dermoscopic variability. The main dermoscopic features described are polymorphous vascular pattern, whiteto- pink halo surrounding the vessels, pink-white structureless areas, vascular structures of glomerular, hairpin vessels, and linear irregular vessels, mimicking amelanotic melanoma, keratinising tumours and several benign and malignant tumors. Eccrine poroma may exhibit polymorphic clinical and dermoscopic features making it difficult to diagnosis and differentiate from other skin cancers.