Scientific letter
Porocarcinoma located in the breast: A case report
Porocarcinoma de localización mamaria, a propósito de un caso
Alba Correa Bonito
, Ángela de la Hoz Rodríguez, Cristina Marín Campos, Beatriz Doblado Cardellach, Elena Martín Pérez
Corresponding author
Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario de La Princesa, Madrid, Spain
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class="elsevierStyleTextfn">Carta científica</span>" "titulo" => "Porocarcinoma de localización mamaria, a propósito de un caso" "tienePdf" => "es" "tieneTextoCompleto" => "es" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "561" "paginaFinal" => "563" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Porocarcinoma Located in the Breast: A Case Report" ] ] "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" => 675 "Ancho" => 900 "Tamanyo" => 119436 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Tumoración exofítica indurada y ulcerada de unos 5<span class="elsevierStyleHsp" 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array:1 [ 0 => "alba.bonito90@gmail.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "Ángela" "apellidos" => "de la Hoz Rodríguez" ] 2 => array:2 [ "nombre" => "Cristina" "apellidos" => "Marín Campos" ] 3 => array:2 [ "nombre" => "Beatriz" "apellidos" => "Doblado Cardellach" ] 4 => array:2 [ "nombre" => "Elena" "apellidos" => "Martín Pérez" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario de La Princesa, Madrid, Spain" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "<span class="elsevierStyleItalic">Corresponding author</span>." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Porocarcinoma de localización mamaria, a propósito de un caso" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0010" "etiqueta" => "Fig. 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 675 "Ancho" => 900 "Tamanyo" => 202731 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0010" "detalle" => "Fig. " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Exophytic mass, with no signs of infection.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Eccrine porocarcinoma is a rare cutaneous neoplasm that arises from the intraepidermal portion of the eccrine sweat glands.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> Its incidence varies between 0.005 and 0.01% of all skin tumors, and it is more common in women over 60 years of age,<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2,3</span></a> although cases have been reported in children and young adults.<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">While the etiology of this neoplasm is unknown, it has been related to chronic sun exposure, exposure to chemical agents, and immunosuppression.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">The presentation is usually as a verrucous mass or nodule that can ulcerate. It is more frequent in the lower extremities (33.9%) and in the head and neck (39.9%).<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> To date, few cases of porocarcinomas in the breast have been published in the literature.<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1,5,6</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">The rates of recurrence and locoregional metastatic extension are high, with multiple nodules in the area of the lesion.<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> Distant metastatic extension (31%) usually has a fatal prognosis and develops mainly in lymph nodes (57.7%) and the lungs (12.8%).</p><p id="par0025" class="elsevierStylePara elsevierViewall">The treatment of choice for this type of tumor is surgical resection of the lesion plus locoregional radiotherapy.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">Despite complete removal of the lesion, recurrence rates are around 20%, distant metastases are found in 12% of patients, and mortality rates are above 50%.<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">We present the case of a 92-year-old woman with a history of arterial hypertension, dyslipidemia, polyarthritis and vitamin D deficiency, who came to the emergency department after having suffered traumatic brain injury in the context of a constitutional syndrome with weight loss over several previous months. During physical examination, an indurated, ulcerated, exophytic mass measuring about 5 × 6 cm was observed on the right breast, with no signs of infection, but capillary bleeding when touched (<a class="elsevierStyleCrossRefs" href="#fig0005">Figs. 1 and 2</a>). The patient reported progressive growth of the lesion over the last 2 years, but had not reported it to her physician.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0040" class="elsevierStylePara elsevierViewall">Lab work detected a hemoglobin level of 8.4 g/dL.</p><p id="par0045" class="elsevierStylePara elsevierViewall">With the suspicion of a mammary neoplasm, and due to the capillary bleeding, we decided to treat the patient surgically with a simple right mastectomy, which was performed without incident. The patient presented good postoperative progress and was discharged 7 days after the intervention.</p><p id="par0050" class="elsevierStylePara elsevierViewall">After the pathology report provided the diagnosis of porocarcinoma, an extension study was ordered, which identified multiple axillary lymphadenopathy clusters on the right side. Given her age, the patient decided not to undergo adjuvant treatment.</p><p id="par0055" class="elsevierStylePara elsevierViewall">Porocarcinoma located in the breast is a very rare entity in the literature. In this case, it was treated surgically, which is the treatment of choice. Although there are no established protocols due to its poor response, in the event of locoregional or distant metastases, treatment can be completed with lymph node resection, radiotherapy and chemotherapy. Our patient herself rejected the treatment due to her advanced age.</p><p id="par0060" class="elsevierStylePara elsevierViewall">In this case, the differential diagnosis included breast carcinoma, and a biopsy would usually have been necessary prior to treatment. However, given that the mastectomy was palliative in this patient, the biopsy would not have changed the therapeutic decision. Early diagnosis is of vital importance in this type of tumors, given their high rates of recurrence and distant disease.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Funding</span><p id="par0065" class="elsevierStylePara elsevierViewall">None.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Conflict of interests</span><p id="par0070" class="elsevierStylePara elsevierViewall">None.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:3 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Funding" ] 1 => array:2 [ "identificador" => "sec0010" "titulo" => "Conflict of interests" ] 2 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Correa Bonito A, de la Hoz Rodríguez Á, Marín Campos C, Doblado Cardellach B, Martín Pérez E. Porocarcinoma de localización mamaria, a propósito de un caso. Cir Esp. 2020. <span class="elsevierStyleInterRef" id="intr0005" href="https://doi.org/10.1016/j.ciresp.2019.12.007">https://doi.org/10.1016/j.ciresp.2019.12.007</span></p>" ] ] "multimedia" => array:2 [ 0 => array:8 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 675 "Ancho" => 900 "Tamanyo" => 119436 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Fig. " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Indurated and ulcerated exophytic mass, measuring some 5 × 6 cm in the right breast.</p>" ] ] 1 => array:8 [ "identificador" => "fig0010" "etiqueta" => "Fig. 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 675 "Ancho" => 900 "Tamanyo" => 202731 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0010" "detalle" => "Fig. " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Exophytic mass, with no signs of infection.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:6 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Porocarcinoma; presentation and management, a meta-analysis of 453 cases" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M.S. 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| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 4 | 0 | 4 |
| 2024 October | 19 | 3 | 22 |
| 2024 September | 18 | 24 | 42 |
| 2024 August | 19 | 10 | 29 |
| 2024 July | 22 | 3 | 25 |
| 2024 June | 10 | 1 | 11 |
| 2024 May | 19 | 5 | 24 |
| 2024 April | 15 | 12 | 27 |
| 2024 March | 32 | 6 | 38 |
| 2024 February | 27 | 5 | 32 |
| 2024 January | 18 | 3 | 21 |
| 2023 December | 37 | 2 | 39 |
| 2023 November | 23 | 3 | 26 |
| 2023 October | 38 | 4 | 42 |
| 2023 September | 27 | 1 | 28 |
| 2023 August | 16 | 1 | 17 |
| 2023 July | 30 | 4 | 34 |
| 2023 June | 40 | 2 | 42 |
| 2023 May | 81 | 3 | 84 |
| 2023 April | 41 | 2 | 43 |
| 2023 March | 43 | 0 | 43 |
| 2023 February | 24 | 4 | 28 |
| 2023 January | 24 | 2 | 26 |
| 2022 December | 29 | 2 | 31 |
| 2022 November | 32 | 4 | 36 |
| 2022 October | 24 | 10 | 34 |
| 2022 September | 28 | 17 | 45 |
| 2022 August | 22 | 17 | 39 |
| 2022 July | 15 | 7 | 22 |
| 2022 June | 19 | 7 | 26 |
| 2022 May | 25 | 6 | 31 |
| 2022 April | 33 | 8 | 41 |
| 2022 March | 37 | 14 | 51 |
| 2022 February | 39 | 6 | 45 |
| 2022 January | 22 | 5 | 27 |
| 2021 December | 28 | 16 | 44 |
| 2021 November | 24 | 7 | 31 |
| 2021 March | 4 | 0 | 4 |
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