VERY LATE RECURRENCE OF A PREVIOUSLY EXCISED SWEAT GLAND CARCINOMA: CASE REPORT WITH REVIEW OF THE LITERATURE

Response of eccrine adenocarcinoma to tamoxifen

One of two patients with systemic metastases from a poorly differentiated eccrine adenocarcinoma of the scalp was found to have a tumor positive for estradiol receptors. In the receptor positive patient, after tamoxifen therapy, the lymph node metastasis regressed completely and was associated with full relief of pain from osseous metastases for nearly 3 years. Subsequently, progressive painful osseous metastases in the spine, skull, pelvis, and femur were palliated for shorter periods with sequential systemic therapy with megestrol acetate and fluoxymesterone. Osseous metastases were also palliated with external radiation therapy. In contrast, despite external radiation therapy, brain metastases proved fatal. Tamoxifen was ineffective in the estradiol receptor negative patient. Based on this report, it may be valuable to determine the presence of estradiol receptor protein in eccrine carcinoma as a predictor of response to hormonal therapy.

Sweat gland carcinoma with bone and visceral metastases. Prolonged complete remission lasting 16 months as a result of chemotherapy

Sweat gland carcinoma is a rare malignant tumor considered to be radio- and chemo-resistant. A case affecting a labium majorum recurred after surgical resection and was accompanied by bone and visceral metastases. After four cycles of combination chemotherapy consisting of doxorubicin, mitomycin C, vincristine and cisplatin, complete remission lasting 16 months and prolonged survival (50 months) were obtained. A review of the literature also is presented.

The significance of atypical nuclear changes in benign eccrine acrospiromas: a clinical and pathological study of 18 cases

A clinicopathologic study of 18 eccrine acrospiromas with atypical nuclear changes is presented. The changes included nuclear pleomorphism, prominent nucleoli, chromatin condensation, multinucleate giant cells and increased mitotic activity. Of the 5 neoplasms that occurred, 2 recurred once and were histologically and clinically benign, and the other 2 recurrences were histologically malignant. One neoplasm recurred twice, the first recurrences being histologically benign and the second histologically malignant. It is suggested that such nuclear atypias in otherwise clinically and histologically benign eccrine acrospiromas may be associated with local benign recurrences some of which may undergo malignant change. Search for these nuclear changes and long follow-up of patients in whom they occur are, therefore, recommended.

Sweat-gland carcinomas: prognosis related to histological type

A series of 10 sweat-gland carcinomas is reported. The ages of the patients at presentation ranged from 12 to 79 years. Three of the tumours had shown long latent periods with a mass present for up to 20 years. Prognosis proved to be related to the histological subtype. Thus, two papillary syringocystadeno-carcinomas, one recurring cylindroma, one hybrid cylindroma/adenoid cystic carcinoma and two mucoid carcinomas were apparently all cured by surgery. Two mucoepidermoid carcinomas and one histologically malignant chondroid syringoma were not only histologically, but also clinically, malignant. The last case, a chondroid syringoma of benign histology, proved nevertheless to be malignant clinically.

Malignant chondroid syringoma of the thigh. Report of a case with electron microscopy of the tumour

A case of malignant chondroid syringoma occurring in a 52-year-old female is reported. The tumour presented as a large, cystic lesion of the thigh. Local recurrence and secondary deposits in the inguinal region occurred at an early stage. The rarity of these malignant tumours and metastasising sweat gland tumours in general is emphasised.

Sweat gland carcinoma

Images