Clinical case
Multiple recurrent eccrine porocarcinoma with inguinal metastasis. A case report
Porocarcinoma ecrino multirrecidivante con metástasis inguinal. Caso clínico
Aida Acosta-Arencibia
, Begoña Abrante-Expósito, Matilde Ramos-Gordillo
Corresponding author
aidacost@hotmail.com
Corresponding author at: Complejo Hospitalario Universitario Insular-Materno Infantil, Secretaría del Servicio de Cirugía Plástica Estética y Reparadora, planta 8a sur, Complejo Hospitalario Universitario Insular-Materno Infantil, Avda. Marítima del Sur, s/n, 35016 Las Palmas de Gran Canaria, Spain. Tel.: +34 928 441 838/629 938 565; fax: +34 928 441 803.
Corresponding author at: Complejo Hospitalario Universitario Insular-Materno Infantil, Secretaría del Servicio de Cirugía Plástica Estética y Reparadora, planta 8a sur, Complejo Hospitalario Universitario Insular-Materno Infantil, Avda. Marítima del Sur, s/n, 35016 Las Palmas de Gran Canaria, Spain. Tel.: +34 928 441 838/629 938 565; fax: +34 928 441 803.
Servicio de Cirugía Plástica, Estética y Reparadora, Complejo Hospitalario Universitario Insular-Materno Infantil, Las Palmas de Gran Canaria, Spain
Read
4865
Timeswas read the article
822
Total PDF
4043
Total HTML
Share statistics
array:24 [ "pii" => "S2444050715001527" "issn" => "24440507" "doi" => "10.1016/j.circen.2015.12.006" "estado" => "S300" "fechaPublicacion" => "2016-01-01" "aid" => "109" "copyrightAnyo" => "2016" "documento" => "simple-article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "crp" "cita" => "Cir Cir. 2016;84:73-6" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 1804 "formatos" => array:3 [ "EPUB" => 37 "HTML" => 1398 "PDF" => 369 ] ] "Traduccion" => array:1 [ "es" => array:19 [ "pii" => "S0009741115001462" "issn" => "00097411" "doi" => "10.1016/j.circir.2015.06.018" "estado" => "S300" "fechaPublicacion" => "2016-01-01" "aid" => "109" "documento" => "simple-article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "crp" "cita" => "Cir Cir. 2016;84:73-6" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 1891 "formatos" => array:3 [ "EPUB" => 57 "HTML" => 1381 "PDF" => 453 ] ] "es" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Caso clínico</span>" "titulo" => "Porocarcinoma ecrino multirrecidivante con metástasis inguinal. Caso clínico" "tienePdf" => "es" "tieneTextoCompleto" => "es" "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "73" "paginaFinal" => "76" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Multiple recurrent eccrine porocarcinoma with inguinal metastasis. A case report" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figura 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1157 "Ancho" => 1543 "Tamanyo" => 301228 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Zona de recidiva rodeada por radiodermitis. Marcaje de extirpación amplia, y diseño del colgajo para cobertura.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Aida Acosta-Arencibia, Begoña Abrante-Expósito, Matilde Ramos-Gordillo" "autores" => array:3 [ 0 => array:2 [ "nombre" => "Aida" "apellidos" => "Acosta-Arencibia" ] 1 => array:2 [ "nombre" => "Begoña" "apellidos" => "Abrante-Expósito" ] 2 => array:2 [ "nombre" => "Matilde" "apellidos" => "Ramos-Gordillo" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S2444050715001527" "doi" => "10.1016/j.circen.2015.12.006" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2444050715001527?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0009741115001462?idApp=UINPBA00004N" "url" => "/00097411/0000008400000001/v1_201602250050/S0009741115001462/v1_201602250050/es/main.assets" ] ] "itemSiguiente" => array:20 [ "pii" => "S2444050715001539" "issn" => "24440507" "doi" => "10.1016/j.circen.2015.12.007" "estado" => "S300" "fechaPublicacion" => "2016-01-01" "aid" => "111" "copyright" => "Academia Mexicana de Cirugía A.C." "documento" => "article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "fla" "cita" => "Cir Cir. 2016;84:77-84" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 2009 "formatos" => array:3 [ "EPUB" => 40 "HTML" => 1641 "PDF" => 328 ] ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">General information</span>" "titulo" => "Update on surgical treatment of primary and metastatic cutaneous melanoma" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "77" "paginaFinal" => "84" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Actualización en el tratamiento quirúrgico del melanoma cutáneo primario y metastásico" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1098 "Ancho" => 901 "Tamanyo" => 216795 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Subungual melanoma which started as longitudinal melanonychia. Hutchinson's sign is present.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "María Alejandra Zuluaga-Sepúlveda, Ivonne Arellano-Mendoza, Jorge Ocampo-Candiani" "autores" => array:3 [ 0 => array:2 [ "nombre" => "María Alejandra" "apellidos" => "Zuluaga-Sepúlveda" ] 1 => array:2 [ "nombre" => "Ivonne" "apellidos" => "Arellano-Mendoza" ] 2 => array:2 [ "nombre" => "Jorge" "apellidos" => "Ocampo-Candiani" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0009741115001486" "doi" => "10.1016/j.circir.2015.06.020" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0009741115001486?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2444050715001539?idApp=UINPBA00004N" "url" => "/24440507/0000008400000001/v1_201603020024/S2444050715001539/v1_201603020024/en/main.assets" ] "itemAnterior" => array:20 [ "pii" => "S2444050715001515" "issn" => "24440507" "doi" => "10.1016/j.circen.2014.11.001" "estado" => "S300" "fechaPublicacion" => "2016-01-01" "aid" => "106" "copyright" => "Academia Mexicana de Cirugía A.C." "documento" => "simple-article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "crp" "cita" => "Cir Cir. 2016;84:69-72" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 1202 "formatos" => array:3 [ "EPUB" => 46 "HTML" => 793 "PDF" => 363 ] ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Clinical case</span>" "titulo" => "Triple synchronous primary gynaecological tumours. A case report" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "69" "paginaFinal" => "72" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Tumores triple sincrónicos ginecológicos. Reporte de un caso" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 969 "Ancho" => 990 "Tamanyo" => 145956 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Macroscopic image of synchronous triple tumour: endometrium, ovary and Fallopian tube.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Laura Gutiérrez-Palomino, José María Romo-de los Reyes, María Jesús Pareja-Megía, José Antonio García-Mejido" "autores" => array:4 [ 0 => array:2 [ "nombre" => "Laura" "apellidos" => "Gutiérrez-Palomino" ] 1 => array:2 [ "nombre" => "José María" "apellidos" => "Romo-de los Reyes" ] 2 => array:2 [ "nombre" => "María Jesús" "apellidos" => "Pareja-Megía" ] 3 => array:2 [ "nombre" => "José Antonio" "apellidos" => "García-Mejido" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0009741115001437" "doi" => "10.1016/j.circir.2015.06.015" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0009741115001437?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2444050715001515?idApp=UINPBA00004N" "url" => "/24440507/0000008400000001/v1_201603020024/S2444050715001515/v1_201603020024/en/main.assets" ] "en" => array:20 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Clinical case</span>" "titulo" => "Multiple recurrent eccrine porocarcinoma with inguinal metastasis. A case report" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "73" "paginaFinal" => "76" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Aida Acosta-Arencibia, Begoña Abrante-Expósito, Matilde Ramos-Gordillo" "autores" => array:3 [ 0 => array:4 [ "nombre" => "Aida" "apellidos" => "Acosta-Arencibia" "email" => array:1 [ 0 => "aidacost@hotmail.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "Begoña" "apellidos" => "Abrante-Expósito" ] 2 => array:2 [ "nombre" => "Matilde" "apellidos" => "Ramos-Gordillo" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Servicio de Cirugía Plástica, Estética y Reparadora, Complejo Hospitalario Universitario Insular-Materno Infantil, Las Palmas de Gran Canaria, Spain" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author at: Complejo Hospitalario Universitario Insular-Materno Infantil, Secretaría del Servicio de Cirugía Plástica Estética y Reparadora, planta 8<span class="elsevierStyleSup">a</span> sur, Complejo Hospitalario Universitario Insular-Materno Infantil, Avda. Marítima del Sur, s/n, 35016 Las Palmas de Gran Canaria, Spain. Tel.: +34 928 441 838/629 938 565; fax: +34 928 441 803." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Porocarcinoma ecrino multirrecidivante con metástasis inguinal. Caso clínico" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1201 "Ancho" => 900 "Tamanyo" => 250790 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Intraoperative image of lifting of the flap.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Background</span><p id="par0005" class="elsevierStylePara elsevierViewall">According to Marone et al.,<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">1</span></a> eccrine porocarcinoma was described in 1963 by Pinkus and Mehregan as epidermotropic eccrine carcinoma. It is a rare type of skin cancer (0.005–0.01% of all skin tumours), which arises from the sweat glands. It can be a primary or a transformation of an eccrine poroma. It has the same incidence in both genders, and principally affects people of advanced age. Fewer than 300 cases have been reported in worldwide medical literature,<a class="elsevierStyleCrossRefs" href="#bib0045"><span class="elsevierStyleSup">1,2</span></a> and its incidence in Europe is rare. Twenty percent of these tumours recur, 10% metastasise to solid organs, and 20% metastasise to regional lymph nodes, with a mortality of almost 70% in the latter. It is difficult to establish an accurate prognosis as there is little follow-up of the cases described because the tumour is so rare.</p><p id="par0010" class="elsevierStylePara elsevierViewall">Clinically it manifests as a solitary lesion, which can be ulcerated nodule in type, or a papule or verrucous lesion. Differential diagnosis can be made with basal cell carcinoma, epidermoid carcinoma, seborrheic keratosis, etc.</p><p id="par0015" class="elsevierStylePara elsevierViewall">The most common location is on the lower limbs, head and neck, and it is less frequent on the trunk, vulva, chest, nail bed, and upper limbs.</p><p id="par0020" class="elsevierStylePara elsevierViewall">Histological diagnostic criteria for eccrine porocarcinoma are an accumulation of atypical cells, some with tubular structures, which emigrate from the epidermis, and are glycogen rich and PAS positive.</p><p id="par0025" class="elsevierStylePara elsevierViewall">The treatment for this type of tumour is by broad surgical excision, Mohs surgery or radiotherapy. Mohs surgery is a surgical technique which enables the removal in layers of selected skin tumours and achieves the highest cure rates. Likewise it enables maximum saving of healthy tissue. All of this is possible through microscopic supervision, which enables 100% analysis of the tumour edges of each of the layers, and thus guide the surgeon through the successive lines of tumour until it is completely removed.</p><p id="par0030" class="elsevierStylePara elsevierViewall">Surgical treatment is curative in 80% of cases. The role of prophylactic radical lymphadenectomy is debatable.<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">3</span></a></p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Clinical case</span><p id="par0035" class="elsevierStylePara elsevierViewall">An 82-year old male patient with a personal history of arterial hypertension, diabetes mellitus and benign prostatic hypertrophy. The patient began with a papulous lesion 4 years previously, which was circular, 1<span class="elsevierStyleHsp" style=""></span>cm in diameter, in the area of the right hip, which was removed with an anatamopathological diagnosis of porocarcinoma, for which he received radiotherapy. He was referred to the plastic surgery unit with local recurrence in the form a of a 1<span class="elsevierStyleHsp" style=""></span>cm papule next to the scar, which was surrounded by an area of major radio dermatitis of 8<span class="elsevierStyleHsp" style=""></span>cm<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>5<span class="elsevierStyleHsp" style=""></span>cm. The patient underwent computed tomography on which right inguinal adenopathies were identified radiologically suspicious of metastasis. A fine-needle aspiration was undertaken (FNA) of these adenopathies which were palpable on physical examination, and were reported as positive malignancies; the remainder of the extension study reported no evidence of distant metastasis.</p><p id="par0040" class="elsevierStylePara elsevierViewall">The patient was operated under general anaesthesia, and an en bloc excision of the area of radio dermatitis was performed including recurrence with more than a 2<span class="elsevierStyleHsp" style=""></span>cm margin of healthy tissue (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>); cover was made using a large rotation flap of the right flank with medial base (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>); and right inguinal lymphadenectomy (<a class="elsevierStyleCrossRef" href="#fig0015">Fig. 3</a>). The anatomopathological report was compatible with recurrence of porocarcinoma, radiodermal changes and broad surgical margins; porocarcinoma metastasis in 2 of the isolated lymph nodes.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia><p id="par0045" class="elsevierStylePara elsevierViewall">There were no incidents in the post-operative period (<a class="elsevierStyleCrossRef" href="#fig0020">Fig. 4</a>). Oncology took over follow-up and evaluation of the patient, they did not administer adjuvant treatment, because no signs suggestive of recurrence were seen on control computed tomography.</p><elsevierMultimedia ident="fig0020"></elsevierMultimedia><p id="par0050" class="elsevierStylePara elsevierViewall">Six months after surgery the patient presented with skin lesions again in the form of papules on the periphery of the flap suggestive of porocarcinoma, which were removed under local anaesthetic, and the suspected diagnosis was confirmed. Further lesions appeared subsequently which were compatible again with local recurrence which extended towards the abdomen and were treated (in the outpatient department) by excision under local anaesthetic (<a class="elsevierStyleCrossRef" href="#fig0025">Fig. 5</a>).</p><elsevierMultimedia ident="fig0025"></elsevierMultimedia><p id="par0055" class="elsevierStylePara elsevierViewall">Three years after the last surgery, the patient continues to have good quality of life, because he has been provided multidisciplinary care, due to his age and the high recurrence rate in a patient of 83, for whom it has been demonstrated that there is no effective systemic treatment. It was decided, therefore, that minor surgery (as an outpatient) for the excision of recurring lesions was the best course of action.</p><p id="par0060" class="elsevierStylePara elsevierViewall">At present, 3 years after surgery, the patient continues to have a good quality of life, and recurrences are being treated in the outpatient department.</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Discussion</span><p id="par0065" class="elsevierStylePara elsevierViewall">Eccine porocarcinoma is a rare skin neoplasm, which derives from the eccrine sweat glands. This tumour can appear de novo or as a progression from a benign poroma, it is very slow growing at onset but after it becomes malignant it behaves aggressively and grows rapidly. It is frequently located on the head and limbs of patients of advanced age (average age 68). Clinically it presents as a nodule, erosive plaque or papule which tends to ulcerate, and can be easily confused with pyogenic granuloma, basal cell carcinoma or amelanotic melanoma.<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">4</span></a></p><p id="par0070" class="elsevierStylePara elsevierViewall">From a histopathological perspective<a class="elsevierStyleCrossRefs" href="#bib0065"><span class="elsevierStyleSup">5,6</span></a> it originates from the intraepidermal portion of the eccrine glands and can be limited to the epidermis or extend to the dermis. The intraepidermal form grows horizontally, and produces pagetoid infiltration in the epidermis: the dermal form shows nodular aggregates with no connection to the epidermis.</p><p id="par0075" class="elsevierStylePara elsevierViewall">Different therapeutic modalities have been applied with eccrine porocarcinoma.<a class="elsevierStyleCrossRefs" href="#bib0075"><span class="elsevierStyleSup">7,8</span></a> Broad excision is curative in 80% of cases, Mohs surgery is useful and 2–4 years of post-operative follow-up without recurrence have been seen. Chemotherapy is reserved for the treatment of metastatic eccrine porocarcinoma, there are no standard protocols, and varying grades of response. Radiation is of little benefit, and is left for palliative care as response is partial. The role of sentinel node biopsy is unknown, and prophylactic lymphadenectomy is controversial. The high recurrence rate of the case presented should be taken into account; even with broad margins of healthy tissue there was recurrence on several occasions.</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Conclusions</span><p id="par0080" class="elsevierStylePara elsevierViewall">Eccrine porocarcinoma, although rare is potentially aggressive with a high recurrence rate and distant metastasis. When malignant there can be a delayed diagnosis as it can be confused with a benign lesion. Treatment consists of surgery with broad margins and thorough follow-up to detect possible recurrence. We consider that early diagnosis by a specialist and rapid surgical treatment is the most appropriate way of achieving a benign prognosis for this aggressive tumour.</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Conflict of interests</span><p id="par0085" class="elsevierStylePara elsevierViewall">The authors have no conflict of interests to declare.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:10 [ 0 => array:3 [ "identificador" => "xres611322" "titulo" => "Abstract" "secciones" => array:3 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Background" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Clinical case" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Conclusion" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec625349" "titulo" => "Keywords" ] 2 => array:3 [ "identificador" => "xres611321" "titulo" => "Resumen" "secciones" => array:3 [ 0 => array:2 [ "identificador" => "abst0020" "titulo" => "Antecedentes" ] 1 => array:2 [ "identificador" => "abst0025" "titulo" => "Caso clínico" ] 2 => array:2 [ "identificador" => "abst0030" "titulo" => "Conclusión" ] ] ] 3 => array:2 [ "identificador" => "xpalclavsec625350" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Background" ] 5 => array:2 [ "identificador" => "sec0010" "titulo" => "Clinical case" ] 6 => array:2 [ "identificador" => "sec0015" "titulo" => "Discussion" ] 7 => array:2 [ "identificador" => "sec0020" "titulo" => "Conclusions" ] 8 => array:2 [ "identificador" => "sec0025" "titulo" => "Conflict of interests" ] 9 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2014-03-28" "fechaAceptado" => "2014-11-30" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec625349" "palabras" => array:3 [ 0 => "Porocarcinoma" 1 => "Lymphadenectomy" 2 => "Recurrent" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec625350" "palabras" => array:3 [ 0 => "Porocarcinoma" 1 => "Linfadenectomía" 2 => "Recurrente" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:3 [ "titulo" => "Abstract" "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Background</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Eccrine porocarcinoma, first described in 1963, is a rare malignant lesion arising from the eccrine sweat glands. It is usually a primary tumour, or even more common, a malignant degeneration of an eccrine poroma. It usually affects older persons and is located most commonly on the lower extremities. About 20% of eccrine porocarcinoma will recur after treatment. The treatment is wide local excision of the primary lesion. This uncommon skin tumour has a locally aggressive behaviour and a high recurrence rate.</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Clinical case</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">An 82 year-old man presenting with multiple recurrent eccrine porocarcinoma with inguinal metastasis. The treatment was a radical excision and inguinal lymphadenectomy. There were no postoperative complications, but there was local recurrence after six months.</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Conclusion</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Early diagnosis and wide excision is the best way to achieve a good prognosis, due to the aggressiveness of this tumour.</p></span>" "secciones" => array:3 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Background" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Clinical case" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Conclusion" ] ] ] "es" => array:3 [ "titulo" => "Resumen" "resumen" => "<span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Antecedentes</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Descrito por primera vez en 1963, el porocarcinoma ecrino es un raro tumour maligno que se desarrolla de las glándulas ecrinas, presentándose como tumour primario, o más frecuentemente mediante transformación maligna de un poroma ecrino. Afecta a pacientes de edad avanzada y la localización más frecuente es en extremidades inferiores. Se observa una recurrencia local del 20% después del tratamiento. La escisión quirúrgica es el tratamiento de elección. Esta infrecuente neoplasia cutánea tiene un comportamiento localmente agresivo y un alto índice de recidiva.</p></span> <span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Caso clínico</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Presentamos el caso de un varón de 82 años con porocarcinoma ecrino multi-recidivado y metástasis ganglionar, tratado con extirpación amplia y linfadenectomía inguinal. Buena evolución postoperatoria. Múltiples recidivas locales a los 6 meses.</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Conclusión</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Debido a su carácter potencialmente agresivo, el diagnóstico precoz y su rápido tratamiento quirúrgico es la forma adecuada de conseguir un pronóstico favorable frente a este tipo de tumor.</p></span>" "secciones" => array:3 [ 0 => array:2 [ "identificador" => "abst0020" "titulo" => "Antecedentes" ] 1 => array:2 [ "identificador" => "abst0025" "titulo" => "Caso clínico" ] 2 => array:2 [ "identificador" => "abst0030" "titulo" => "Conclusión" ] ] ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Acosta-Arencibia A, Abrante-Expósito B, Ramos-Gordillo M. Porocarcinoma ecrino multirrecidivante con metástasis inguinal. Caso clínico. Cir Cir. 2016;84:73–76.</p>" ] ] "multimedia" => array:5 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 695 "Ancho" => 926 "Tamanyo" => 110399 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Area of recurrence surrounded by radiodermatitis. Marking of broad excision, and design of flap for cover.</p>" ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1201 "Ancho" => 900 "Tamanyo" => 250790 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Intraoperative image of lifting of the flap.</p>" ] ] 2 => array:7 [ "identificador" => "fig0015" "etiqueta" => "Figure 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 694 "Ancho" => 926 "Tamanyo" => 85649 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Design of right inguinal lymphadenectomy.</p>" ] ] 3 => array:7 [ "identificador" => "fig0020" "etiqueta" => "Figure 4" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr4.jpeg" "Alto" => 694 "Ancho" => 926 "Tamanyo" => 95920 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Postsurgical result.</p>" ] ] 4 => array:7 [ "identificador" => "fig0025" "etiqueta" => "Figure 5" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr5.jpeg" "Alto" => 675 "Ancho" => 900 "Tamanyo" => 85844 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Lesions compatible with recurrence adjacent to the flap scar.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:8 [ 0 => array:3 [ "identificador" => "bib0045" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Metastatic eccrine porocarcinoma: report of a case and review of the literature" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "U. Marone" 1 => "C. Caracò" 2 => "A.M. Anniciello" 3 => "G. di Monta" 4 => "M.G. Chiofalo" 5 => "M.L. di Cecilia" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1186/1477-7819-9-32" "Revista" => array:5 [ "tituloSerie" => "World J Surg Oncol" "fecha" => "2011" "volumen" => "9" "paginaInicial" => "32" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21410982" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0050" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Porocarcinoma ecrino: un tumor cutáneo infrecuente con alta incidencia en Navarra" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "J.A. Lozano" 1 => "J. Andueza" 2 => "A. Valcayo" 3 => "R. Guarsch" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Anales Sis San Navarra" "fecha" => "1998" "volumen" => "21" "paginaInicial" => "167" "paginaFinal" => "171" ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0055" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Primary eccrine porocarcinoma of the finger with transit forearm and axillary metastasis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "W. Bhat" 1 => "S. Akhtar" 2 => "A. Khotwal" 3 => "A.J. Platt" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/SAP.0b013e3181e35c8d" "Revista" => array:6 [ "tituloSerie" => "Ann Plast Surg" "fecha" => "2011" "volumen" => "66" "paginaInicial" => "344" "paginaFinal" => "346" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21042176" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0060" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Porocarcinoma eccrine" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "C.W. Brown Jr." 1 => "L.C. Dy" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1529-8019.2008.00243.x" "Revista" => array:6 [ "tituloSerie" => "Dermatol Ther" "fecha" => "2008" "volumen" => "21" "paginaInicial" => "433" "paginaFinal" => "438" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19076620" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0065" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Metastazing eccrine porocarcinoma: report of the case and review of the literature" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "P. Huet" 1 => "M. Dandurand" 2 => "C. Pignodel" 3 => "B. Guillot" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Am Acad Dermatol" "fecha" => "1996" "volumen" => "35" "paginaInicial" => "860" "paginaFinal" => "864" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8912607" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0070" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Porome eccrine et porocarcinome" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "E. Arbona" 1 => "B. Balme" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.annder.2010.07.008" "Revista" => array:6 [ "tituloSerie" => "Ann Dermatol Venereol" "fecha" => "2010" "volumen" => "137" "paginaInicial" => "660" "paginaFinal" => "662" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20932451" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0075" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Eccrine porocarcinoma of the scalp" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "S. Ekmekci" 1 => "B. Lebe" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Turk Patoloji Derq" "fecha" => "2013" "volumen" => "29" "paginaInicial" => "156" "paginaFinal" => "159" ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0080" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Treatment of multiple bilateral primary eccrine porocarcinoma with topical diphencyprone: a case report" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "A. Kutty" 1 => "F. Harper" 2 => "V. Akhras" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/bjd.12470" "Revista" => array:6 [ "tituloSerie" => "Br J Dermatol" "fecha" => "2013" "volumen" => "169" "paginaInicial" => "1159" "paginaFinal" => "1161" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23773127" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/24440507/0000008400000001/v1_201603020024/S2444050715001527/v1_201603020024/en/main.assets" "Apartado" => array:4 [ "identificador" => "44602" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Clinical Cases" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/24440507/0000008400000001/v1_201603020024/S2444050715001527/v1_201603020024/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2444050715001527?idApp=UINPBA00004N" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 12 | 0 | 12 |
| 2024 October | 32 | 5 | 37 |
| 2024 September | 39 | 3 | 42 |
| 2024 August | 44 | 4 | 48 |
| 2024 July | 45 | 6 | 51 |
| 2024 June | 62 | 8 | 70 |
| 2024 May | 84 | 3 | 87 |
| 2024 April | 72 | 4 | 76 |
| 2024 March | 49 | 7 | 56 |
| 2024 February | 56 | 1 | 57 |
| 2024 January | 60 | 3 | 63 |
| 2023 December | 76 | 3 | 79 |
| 2023 November | 56 | 14 | 70 |
| 2023 October | 56 | 4 | 60 |
| 2023 September | 45 | 3 | 48 |
| 2023 August | 42 | 7 | 49 |
| 2023 July | 59 | 5 | 64 |
| 2023 June | 54 | 2 | 56 |
| 2023 May | 69 | 4 | 73 |
| 2023 April | 47 | 4 | 51 |
| 2023 March | 50 | 3 | 53 |
| 2023 February | 44 | 11 | 55 |
| 2023 January | 56 | 4 | 60 |
| 2022 December | 29 | 7 | 36 |
| 2022 November | 43 | 9 | 52 |
| 2022 October | 43 | 15 | 58 |
| 2022 September | 43 | 21 | 64 |
| 2022 August | 41 | 19 | 60 |
| 2022 July | 30 | 7 | 37 |
| 2022 June | 35 | 8 | 43 |
| 2022 May | 22 | 10 | 32 |
| 2022 April | 27 | 10 | 37 |
| 2022 March | 54 | 9 | 63 |
| 2022 February | 45 | 7 | 52 |
| 2022 January | 80 | 7 | 87 |
| 2021 December | 60 | 12 | 72 |
| 2021 November | 67 | 8 | 75 |
| 2021 October | 72 | 12 | 84 |
| 2021 September | 60 | 13 | 73 |
| 2021 August | 37 | 6 | 43 |
| 2021 July | 30 | 11 | 41 |
| 2021 June | 31 | 16 | 47 |
| 2021 May | 33 | 6 | 39 |
| 2021 April | 71 | 20 | 91 |
| 2021 March | 49 | 12 | 61 |
| 2021 February | 36 | 9 | 45 |
| 2021 January | 44 | 9 | 53 |
| 2020 December | 63 | 11 | 74 |
| 2020 November | 53 | 9 | 62 |
| 2020 October | 33 | 7 | 40 |
| 2020 September | 31 | 8 | 39 |
| 2020 August | 32 | 10 | 42 |
| 2020 July | 21 | 6 | 27 |
| 2020 June | 26 | 12 | 38 |
| 2020 May | 33 | 11 | 44 |
| 2020 April | 21 | 1 | 22 |
| 2020 March | 28 | 2 | 30 |
| 2020 February | 27 | 10 | 37 |
| 2020 January | 28 | 6 | 34 |
| 2019 December | 31 | 16 | 47 |
| 2019 November | 29 | 8 | 37 |
| 2019 October | 13 | 4 | 17 |
| 2019 September | 40 | 5 | 45 |
| 2019 August | 11 | 3 | 14 |
| 2019 July | 16 | 12 | 28 |
| 2019 June | 83 | 11 | 94 |
| 2019 May | 196 | 14 | 210 |
| 2019 April | 87 | 11 | 98 |
| 2019 March | 9 | 4 | 13 |
| 2019 February | 23 | 8 | 31 |
| 2019 January | 12 | 3 | 15 |
| 2018 December | 9 | 3 | 12 |
| 2018 November | 26 | 6 | 32 |
| 2018 October | 43 | 10 | 53 |
| 2018 September | 52 | 4 | 56 |
| 2018 August | 13 | 4 | 17 |
| 2018 July | 14 | 3 | 17 |
| 2018 June | 9 | 0 | 9 |
| 2018 May | 13 | 3 | 16 |
| 2018 April | 12 | 1 | 13 |
| 2018 March | 7 | 2 | 9 |
| 2018 February | 14 | 0 | 14 |
| 2018 January | 11 | 3 | 14 |
| 2017 December | 11 | 3 | 14 |
| 2017 November | 9 | 2 | 11 |
| 2017 October | 10 | 2 | 12 |
| 2017 September | 14 | 9 | 23 |
| 2017 August | 18 | 4 | 22 |
| 2017 July | 13 | 7 | 20 |
| 2017 June | 16 | 4 | 20 |
| 2017 May | 26 | 3 | 29 |
| 2017 April | 16 | 0 | 16 |
| 2017 March | 16 | 84 | 100 |
| 2017 February | 39 | 3 | 42 |
| 2017 January | 13 | 1 | 14 |
| 2016 December | 22 | 5 | 27 |
| 2016 November | 37 | 5 | 42 |
| 2016 October | 49 | 9 | 58 |
| 2016 September | 83 | 8 | 91 |
| 2016 August | 24 | 8 | 32 |
| 2016 July | 22 | 1 | 23 |
| 2016 June | 30 | 7 | 37 |
| 2016 May | 31 | 21 | 52 |
| 2016 April | 29 | 10 | 39 |
| 2016 March | 55 | 24 | 79 |
Show all