Extracalvarial Porocarcinoma- A Rare Case Report

Eccrine Porocarcinoma (EPC) is a very rare malignant neoplasm of skin. It usually emerges from the ductal parts of sweat glands. It is seen mostly between the age group of 60 to 80 years with a female preponderance. Several cases of EPC have been reported in medical literature till date. Though, it rarely presents with distant metastasis, still evidences of metastasis to organs like lung, retroperitoneum, breast, urinary bladder and ovaries have been reported. Conventionally, it arises de novo, and may develop on sites of long standing eccrine poroma. Several unusual sites like trunk, head, face, eyelids, upper limbs, and scrotum have been reported; though lower extremities are the most common site of origin. Locoregional recurrence and metastasis have also been reported. Histopathological documentation of mitoses, lymphovascular invasion and measurement of tumour depth predicts adverse prognosis in EPC. Earlier, eccrine adenocarcinoma or malignant eccrine poroma terminology were used. As far as clinical presentation is concerned, the EPC is usually symptomless to begin with, which further ulcerates and may become aching and irritable. From a clinicopathological perspective the importance of the tumour lies in its early correct diagnosis, awareness of the close differentials, adequate surgery and most importantly clearance of surgical margins and adjuvant radiotherapy are mandatory decisions to prevent the high local recurrence. The basis of management involves wide local excision with clear margin. The following case, a 42-year-old male presented with an ulcerated mass on the scalp, which on further evaluation was diagnosed as an EPC of the scalp after histopathologic confirmation. The patient was treated with local wide excision with clear margin and was referred for radiotherapy.