Vulvar Porocarcinoma with Inguinal Nodal Recurrence: A Case Report

Main Article Content

Hannah J Porter
Nadeem Marghoob
Hayden Christensen
Matthew Dinehart
Conor O'Neill
Mark Wick
Laura Greene
Christine H Weinberger

Keywords

Porocarcinoma, Cutaneous Oncology

Abstract

Introduction: Porocarcinoma (PC) is an uncommon, aggressive malignancy of the sweat gland apparatus characterized by diverse clinical presentation and challenging histopathology. Patients diagnosed with PC face a grim prognosis due to high rates of recurrence and metastasis.


Case Report: We present a case of a vulvar porocarcinoma initially managed by surgical excisions, achieving clear margins. Subsequent surveillance revealed regional lymph node metastasis, prompting lymph node dissection.


Discussion: Here, we highlight the difficulty in recognizing and managing PC. While surgical excision remains the mainstay of treatment, there exists no consensus on adjuvant therapies and the role of sentinel lymph node biopsy at diagnosis. Given its rarity, diagnostic complexities, and aggressive behavior, PC warrants a collaborative approach to maximize patient outcomes.

References

1. Joshy J, Mistry K, Levell NJ, et al. Porocarcinoma: a review. Clin Exp Dermatol. 2022;47(6):1030-1035. DOI: 10.1111/ced.15126

2. Mehregan AH, Hashimoto K, Rahbari H. Eccrine adenocarcinoma. Arch Dermatol. 1983;119:104–14. doi:10.1001/archderm.1983.01650260012008

3. Wick MR, Goellner JR, Wolfe JT III, et al. Adnexal carcinomas of the skin. I: Eccrine carcinomas. Cancer. 1985;56:1147–62. doi:10.1002/1097-0142(19850901)56:5<1147::aid-cncr2820560532>3.0.co;2-3

4. Wick MR, Goellner JR, Wolfe JT, Su WP. Vulvar sweat gland carcinomas. Arch Pathol Lab Med. 1985;109:43–7.

5. Katsanis WA, Doering DL, Bosscher JR, O'Connor DM. Vulvar eccrine porocarcinoma. Gynecol Oncol. 1996 Sep;62(3):396-9. doi: 10.1006/gyno.1996.0255. PMID: 8812539.

6. Adegboyega PA. Eccrine porocarcinoma of the vulva: a case report and review of literature. Int J Gynecol Pathol. 2011;30(1):95-100. doi: 10.1097/PGP.0b013e3181ea11b1.

7. Robson A, Greene J, Ansari N, Kim B, Seed PT, McKee PH, Calonje E. Eccrine porocarcinoma (malignant eccrine poroma): a clinicopathologic study of 69 cases. Am J Surg Pathol. 2001 Jun;25(6):710-20. doi: 10.1097/00000478-200106000-00002. PMID: 11395548.

8. Olmos Nieva CC, Samaniego González E, González Morán MA, Rodríguez Prieto MA. Eccrine Porocarcinoma: A Clinical and Histologic Description of a Series of 11 Cases Treated at the University Hospital Complex in Leon, Spain. Porocarcinoma ecrino: estudio clínico-histológico de una serie de 11 casos del Complejo Asistencial Universitario de León. Actas Dermosifiliogr (Engl Ed). 2021;112(5):478-481. doi:10.1016/j.ad.2020.01.007

9. Prieto-Granada C, Morlote D, Pavlidakey P, et al. Poroid adnexal skin tumors with YAP1 fusions exhibit similar histopathologic features: A series of six YAP1-rearranged adnexal skin tumors. J Cutan Pathol. 2021;48(9):1139-1149. doi:10.1111/cup.14008

10. Reina S, Palombo D, Boscaneanu A, et al. Sentinel lymph node biopsy in porocarcinoma: A case reports. Int J Surg Case Rep. 2018;53:196-199. doi:10.1016/j.ijscr.2018.10.047

11. Xu YG, Aylward J, Longley BJ, Hinshaw MA, Snow SN. Eccrine Porocarcinoma Treated by Mohs Micrographic Surgery: Over 6-Year Follow-up of 12 Cases and Literature Review. Dermatol Surg. 2015;41(6):685-692. doi:10.1097/DSS.0000000000000382

12. Tsunoda K, Onishi M, Maeda F, Akasaka T, Sugai T, Amano H. Evaluation of Sentinel Lymph Node Biopsy for Eccrine Porocarcinoma. Acta Derm Venereol. 2019;99(7):691-692. doi:10.2340/00015555-3173