epidermotropic eccrine carcinoma

EPIDERMOTROPIC ECCRINE CARCINOMA

This middle age male presented with bilateral edema of the lower extremities and genitalia plus macular erythematous areas on the abdomen as well as verrucous plaques and papules, mostly on the lower extremities. Some of the papular lesions and plaques were pigmented. He died about a year later. An autopsy was not performed.

Sections of some of the hyperpigmented areas (not illustrated here) demonstrated dendritic melanocytes parasitizing nests of tumor. The widespread involvement is presumably due to lymphatic spread.

Pinkus and Mehregan described the first case (without pigmented lesions), and there have been a few case reports since their paper.

Clinical photograph showing erythematous macular areas on lower abdomen, edema of the lower extremities plus a variety of papules and plaques, some of which are pigmented.

Note: I took these photomicrographs almost 30 years ago. They were not too good then, and they have deteriorated since.

Scan power view. A few nests of tumor are in the epidermis. The dermal component is occasionally found in lymphatics in a manner similar to that which can be seen in inflammatory carcinoma of the breast. The latter would account for the macular, erythematous areas. Solid nests of tumor are also present.

High power view of an intraepidermal tumor. The surface could be either interpreted as parakeratosis or as 'necrosis en masse' of the type characteristically found in some eccrine tumors of skin. Many of the tumor cells in this area have clear cytoplasm, a nonspecific finding.

High power view of a dermal nodule showing intracytoplasmic lumen formation, a feature found in some eccrine tumors. A few tiny keratohyalin granules are also seen, and these tiny granules are sometimes found in eccrine acrosyringeal tumors, particularly near lumina.

Reference:
Pinkus H, Mehregan AH: Epidermotropic eccrine carcinoma: A case combining features of eccrine poroma and Paget's dermatosis. Arch Dermatol 88:597, 1963.

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	Scan power view. A few nests of tumor are in the epidermis. The dermal component is occasionally found in lymphatics in a manner similar to that which can be seen in inflammatory carcinoma of the breast. The latter would account for the macular, erythematous areas. Solid nests of tumor are also present.
	High power view of an intraepidermal tumor. The surface could be either interpreted as parakeratosis or as 'necrosis en masse' of the type characteristically found in some eccrine tumors of skin. Many of the tumor cells in this area have clear cytoplasm, a nonspecific finding.
	High power view of a dermal nodule showing intracytoplasmic lumen formation, a feature found in some eccrine tumors. A few tiny keratohyalin granules are also seen, and these tiny granules are sometimes found in eccrine acrosyringeal tumors, particularly near lumina.