Eccrine Carcinoma

 Presence of keratocysts allows for distinction (absent in eccrine carcinoma)



• Adenoid cystic carcinoma
image Cribriform architecture allows distinction (generally absent in eccrine carcinoma)

• Infiltrative basal cell carcinoma
image Lacks true lumen formation
– Typically negative for EMA and CEA

image Often has epidermal attachments

image May have other basal cell carcinoma subtypes



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Eccrine Carcinoma With Deep Invasion
Eccrine carcinoma is a dermal-based tumor composed of infiltrating ducts/glands associated with a sclerotic stroma. The tumor is often deeply infiltrative, with invasion into the deep dermis and subcutaneous adipose tissue in most cases.


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Eccrine Carcinoma With Subcutaneous Invasion
Eccrine carcinoma is very infiltrative and often extends into the underlying subcutaneous fat, as in this case.

image
Eccrine Carcinoma at Higher Magnification
Higher magnification of the infiltrative ducts shows significant atypia, with nuclear hyperchromasia, crowding, and a few mitotic figures image.

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Eccrine Carcinoma With Perineural Invasion
Perineural invasion is a common and expected finding in many eccrine carcinomas.


TERMINOLOGY


Synonyms




• Syringoid carcinoma, syringoid eccrine carcinoma, eccrine syringomatous carcinoma, eccrine epithelioma


Definitions




• Malignant adnexal tumor with eccrine differentiation somewhat resembling syringoma
image No evidence of association with or development from syringomas

• Some authorities group these tumors with microcystic adnexal carcinoma (MAC)


CLINICAL ISSUES


Epidemiology




• Incidence
image Very rare tumors

• Age
image Usually present in middle-aged patients

• Sex
image More common in women (3:1)


Site




• Most common on scalp

• May also present on face, neck, trunk, or extremities


Presentation




• Typically present as plaque or nodule
image May present as painful lesion ± alopecia

image May be present for many years before diagnosis

Apr 24, 2017 | Posted by in PATHOLOGY & LABORATORY MEDICINE | Comments Off on Eccrine Carcinoma
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