Squamoid Eccrine Ductal Carcinoma Research Articles

Squamoid Eccrine Ductal Carcinoma: An Unusual Diagnosis in a Pregnant Patient

Squamoid Eccrine Ductal Carcinoma: An Unusual Diagnosis in a Pregnant Patient

All that is squamoid is not squamous: A rare case of Squamoid Eccrine Ductal Carcinoma presenting as an intranasal mass

Abstract Introduction/Objective Squamoid eccrine ductal carcinoma (SEDC) is a rare adnexal tumor that poses diagnostic challenges because of the rarity, variable clinical presentation, and misdiagnosis on superficial biopsy sampling. Methods/Case Report We report a 52-year-old immunosuppressed male, status-post kidney and heart transplants who presented with an anterior nasal mass, the biopsy of which was interpreted as squamous cell carcinoma (SCC). Resection revealed a 2.5cm intranasal mass eroding through the hard palate. Histology showed a biphasic tumor arising from nasal vestibular skin with a superficial squamoid component (p40 positive) and a deeply invasive component demonstrating ductal differentiation (CEA positive) consistent with SEDC. SEDC has a predilection towards skin of head and neck region but SEDC presenting as an intranasal mass has not been reported. In our case, the tumor arose from nasal vestibular skin with destructive bony invasion within the nasal cavity. The patient’s long- term immunosuppression likely played a role in the etiopathogenesis and aggressive progression of this tumor. Interestingly, he also had history of multiple sebaceous carcinomas and cutaneous T-cell lymphoma with no known genetic predisposition, further implicating immunosuppression as the key risk factor for development of his cutaneous malignances. Results (if a Case Study enter NA) N/A Conclusion This case exemplifies the potential diagnostic pitfalls in squamoid lesions of the head and neck. Given the overwhelming prevalence of conventional SCC, rarer tumors with squamous differentiation often are not considered in the differential diagnosis, especially of an intranasal mass. A superficial biopsy often is misdiagnosed as SCC due to the lack of representation of deep-seated ductal components. A high index of suspicion and adequate examination of deeper aspects of the lesion are imperative for accurate diagnosis.

Squamoid eccrine ductal carcinoma of the vulva: A case report

Abstract Introduction/Objective A 53-year-old female sought medical attention for left vulvar pain and a vulvar lesion. Methods/Case Report Physical examination revealed a 1.0 x 1.0 cm lesion within a background of lichen sclerosus. Biopsy demonstrated a carcinoma with tubular and glandular architecture, areas of squamoid differentiation and widespread perineural invasion. Ancillary immunohistochemistry testing with keratin 7 highlighted foci of ductal differentiation. Tumor cells were also positive for p53, p63, pankeratin, and keratin 5/6. The Ki-67 proliferation index was approximately 15%. Tumor cells were negative for Keratin 20, PAX 8, p16, and CD 34. We diagnosed the lesion as a vulvar sweat gland adenocarcinoma of the squamoid eccrine ductal subtype. Results (if a Case Study enter NA) N/A Conclusion Carcinomas of vulvar sweat gland origin are extremely rare, comprising less than 1% of all vulvar cancers. To the best of our knowledge, this is the first case report of squamoid eccrine ductal carcinoma afflicting the vulva.

Squamoid Eccrine Ductal Carcinoma Displays Ultraviolet Mutations and Intermediate Gene Expression Relative to Squamous Cell Carcinoma, Microcystic Adnexal Carcinoma, and Porocarcinoma

Squamoid eccrine ductal carcinoma is a rare infiltrative tumor with morphologic features intermediate between squamous cell carcinoma (SCC) and sweat gland carcinomas such as microcystic adnexal carcinoma. Although currently classified as a sweat gland carcinoma, it has been debated whether squamoid eccrine ductal carcinoma is better classified as a variant of SCC. Furthermore, therapeutic options for patients with advanced disease are lacking. Here, we describe clinicopathologic features of a cohort of 15 squamoid eccrine ductal carcinomas from 14 unique patients, with next-generation sequencing DNA profiling for 12 cases. UV signature mutations were the dominant signature in the majority of cases. TP53 mutations were the most highly recurrent specific gene alteration, followed by mutations in NOTCH genes. Recurrent mutations in driver oncogenes were not identified. By unsupervised comparison of global transcriptome profiles in squamoid eccrine ductal carcinoma (n = 7) to SCC (n = 10), porocarcinoma (n = 4), and microcystic adnexal carcinoma (n = 4), squamoid eccrine ductal carcinomas displayed an intermediate phenotype between SCC and sweat gland tumors. Squamoid eccrine ductal carcinoma displayed significantly higher expression of 364 genes (including certain eccrine markers) and significantly lower expression of 525 genes compared with other groups. Our findings support the classification of squamoid eccrine ductal carcinoma as a carcinoma with intermediate features between SCC and sweat gland carcinoma.

Squamoid eccrine ductal carcinoma: clinical, histological and immunohistochemical features.

Squamoid eccrine ductal carcinoma (SEDC) is a cutaneous adnexal malignancy that is histologically challenging to distinguish from squamous cell carcinoma. We report three cases of this rare entity and review the present literature regarding clinical, histological, and immunohistochemical features. Patients presented with a single nodule or plaque lesion on their back and temple. The shave biopsies for Patient A and C were interpreted as SEDC. Patient B's initial shave biopsy was interpreted as probable surface of squamous cell carcinoma, and subsequent excision revealed SEDC. Ductal differentiation was confirmed by positive expression of epithelial membrane antigen and carcinoembryonic antigen immunostains in all three patients. Review of the 67 previously reported cases emphasizes the importance of diagnosing SEDC accurately and promptly given its potential for distant metastasis and mortality. Perineural or lymphatic invasion is associated with higher rate of recurrence or metastasis. There should be high pathologic suspicion for SEDC in an elderly patient presenting with a palpable lesion, even if located outside of the head and neck area, particularly when there is suggestion of ductal differentiation in a sample of a squamous neoplasm.

Mohs surgery for squamoid eccrine ductal carcinoma

Abstract Squamous eccrine ductal carcinoma is a rare cutaneous malignancy. It has the potential to locally recur and may occasionally metastasize. It presents a diagnostic challenge given its rare nature and overlapping histopathological features with other cutaneous carcinomas.

A Case of Squamoid Eccrine Ductal Carcinoma of the Auricle Mimicking Perichondritis.

The subtype of eccrine carcinoma known as squamoid eccrine ductal carcinoma (SEDC) is rare; only 38 cases, including only 6 cases in the ear, have been documented in the literature. This may be the first case to focus on the fact that SEDC, located within the dermal and subcutaneous layers, spares the epidermis histopathologically, which can cause clinicians to confuse SEDC with acute perichondritis.

Whole-Exome Sequencing of a Case of Squamoid Eccrine Ductal Carcinoma Reveal Similarities With Cutaneous Squamous Cell Carcinoma.

Squamoid eccrine ductal carcinoma (SEDC) is a poorly documented but likely underrecognized sweat gland malignancy with significant risk for local recurrence and potential for metastasis and rare disease-related mortality. Histopathologically, the tumor demonstrates a biphasic differentiation pattern: superficially, the tumor has squamous differentiation [indistinguishable from well-differentiated cutaneous squamous cell carcinoma (cSCC)], while the deeper aspect has a more infiltrative pattern with prominent ductal differentiation. Diagnosis of SEDC relies upon histopathologic examination alone. Its pathogenesis is poorly understood, and its genomic features have yet to be described. In this article, we characterize the genomic features in a case of SEDC through whole-exome sequencing, then compare its features with cSCC and other eccrine ductal carcinomas. Whole-exome sequencing revealed 30 mutations/Mb with 21 pathogenic or likely pathogenic mutations in total, identified across 14 different genes. The genomic abnormalities identified in this case of SEDC overlap considerably with those found in cSCC but not those of other sweat gland malignancies. The clinical and histopathologic features of SEDC previously reported and the genetic features determined from this case suggest that this tumor may arise initially as a well-differentiated cSCC that subsequently undergoes divergent differentiation focally to resemble a sweat gland malignancy. Genetic analyses of additional cases are warranted to clarify this consideration.

Squamoid Eccrine Ductal carcinoma of the axilla treated with complex oncological and reconstructive surgery: A case report

Squamoid Eccrine Ductal carcinoma of the axilla treated with complex oncological and reconstructive surgery: A case report

Squamoid Eccrine Ductal Carcinoma of the Eyelid: Clinicopathologic Correlation of a Case

Squamoid eccrine ductal carcinoma (SEDC) is a rare cutaneous neoplasm that often manifests as a plaque or nodule in sun-exposed areas of older patients. Herein, the authors report the first case of SEDC in the eyelid. A 76-year-old man presented with a 2.5 × 1.5 mm area of left upper eyelid erythema, thickening, ulceration, and scaling with madarosis superotemporally just above the lash line. Full-thickness wedge biopsy demonstrated irregular epithelial tubules with nuclear atypia and focal squamous differentiation, consistent with SEDC. The patient underwent Mohs resection and has had no recurrence approximately 27 months after surgical removal. The authors present this case to raise awareness of SEDC to ophthalmologists as all previous cases have been described in the nonophthalmic literature. A full-thickness biopsy is recommended to avoid misdiagnosing SEDC as squamous cell carcinoma (SCC), a less aggressive tumor. With greater awareness, there may be increased recognition of this likely underreported, more malignant entity.

Head and Neck Sweat Gland Carcinomas: Clinical Characteristics and Patterns of Care

<h3>Purpose/Objective(s)</h3> Little is known about head and neck malignancies originating from cutaneous adnexal tissue. Using the National Cancer Database (NCDB), we attempted to characterize patients with malignant sweat gland carcinomas of the head and neck region. <h3>Materials/Methods</h3> Adult patients with malignant head and neck sweat gland carcinomas diagnosed between 2004-2018 in the NCDB were selected. Demographics, comorbidities, tumor characteristics, and treatments were analyzed. Patients with unknown survival outcomes, no surgical treatment, less than six months of follow-up, previous malignancies, or T0 tumors were excluded from survival analysis. Kaplan-Meier analysis was used to assess overall survival at three and five years. Cox proportional-hazards regression was used to assess for predictors of overall survival. <h3>Results</h3> We identified 2723 patients with sweat gland carcinomas in the NCDB. The median age was 68 years (range: 20-90), and 1366 patients (50.2%) were female. The most common histology was microcystic adnexal carcinoma (676, 24.8%) followed by mucinous carcinoma (535, 19.6%) and porocarcinoma (419, 15.4%). Of patients with complete staging information, most were staged as T1 (916, 63.0%), N0 (1871, 97.2%), and M0 (2278, 99.3%). Nodal metastases were present in 94 patients (10.1%). The highest rates of nodal disease were observed in apocrine adenocarcinoma (29.0%), squamoid eccrine ductal carcinoma (17.5%), and porocarcinoma (16.6%). Excluding these histologies, the nodal metastasis rate was 6.5%. 2559 patients (95.4%) were treated with surgery. Of these, 334 (12.9%) received adjuvant radiation and 29 (1.1%) received chemoradiation. Three-year and five-year overall survival rates were 88.1% (95% CI: 86.5%-89.6%) and 80.3% (78.3%-82.4%), respectively. On univariable analysis, age, male gender, white race, comorbidities, treatment at a community hospital, tumor size >1cm, T and N stage, lymphovascular invasion, and positive margins were associated with worse survival. Age, male gender, comorbidities, size >1cm, and nodal stage retained their significance in multivariable analysis. <h3>Conclusion</h3> Sweat gland carcinomas are a diverse group of rare malignancies. While the rate of nodal metastases is low, certain histologies harbor higher potential for lymph node metastases with worse survival. Tumor size larger than 1cm is also associated with worse survival. The above data could help clinicians in the management of these rare tumors.

Squamoid Eccrine Ductal Carcinoma: Treatment and Outcomes

Squamoid eccrine ductal carcinoma (SEDC) represents a subtype of eccrine carcinomas that are diagnostically challenging for both clinicians and dermatopathologists. To provide an updated review of SEDC and examine patient outcomes with different treatment modalities. A review of Ovid MEDLINE was performed to review the English language medical literature of SEDC. A comprehensive review of clinical presentation, histologic findings, rates of lymphovascular and metastatic disease, treatment modalities and recurrence rates are reviewed. There is a limitation on available data because of the rare incidence. SEDC is a rare adnexal neoplasm with a relatively high rate of local recurrence, lymphovascular invasion, perineural invasion, and metastases. Clinicians should be aware of this entity as close follow-up is essential to detect recurrence and metastatic disease. Mohs micrographic surgery seems to result in superior patient outcomes.

26453 Squamoid eccrine ductal carcinoma of the nose requiring extensive resection and reconstruction

A 69-year-old male presented to dermatology with a 1-year history of an enlarging 3-cm ill-defined, indurated, sclerotic, and ulcerated mass on the nasal tip. Shave biopsy demonstrated squamous cell carcinoma (SCC) with atypical squamous cells exhibiting epithelioid and infiltrative patterns. Tissue from the Mohs debulk demonstrated a poorly differentiated carcinoma diffusely infiltrating the dermis with perineural invasion. Tumor cells were predominantly epithelioid cells with clear to eosinophilic cytoplasm forming cords, nests with occasional lumen, and focally diffuse sheets that exhibited positivity for CK5/6, CK7, p40, p63, EMA, Lu-5, D240, and CEA. Histologic and immunohistochemical features were consistent with squamoid eccrine ductal carcinoma (SEDC). The peripheral margin and majority of the deep margin were cleared with Mohs surgery. Due to invasion into the nasal septum, further excision and repair was done by ENT Facial Plastics. Clear margins were obtained. CT imaging was negative for intracranial metastasis, neck masses, or regional lymphadenopathy. SEDC is a rare subtype of eccrine carcinoma with approximately 60 reported cases since initial description in 1997. Lesions appear as ulcerated nodules or plaques on sun exposed skin. Histologic features include superficial atypical squamous proliferation with deeper eccrine ductal differentiation and immunohistologic positivity indicative of eccrine origin. Lack of characteristic ductal features in the superficial portion of the tumor has led to initial misdiagnosis as SCC in shallow biopsies. SEDC has a 13% rate of metastasis with 1 reported death and multiple reports of local recurrence after wide excision. Outstanding clinical and histologic images will be presented.

25662 Squamoid eccrine ductal carcinoma

A 73-year-old male with a history of squamous cell carcinoma presented with an asymptomatic growing lesion on his right ear present for several months. Physical examination revealed a 2-cm firm pink nodule without bleeding or ulceration on the right superior postauricular ear. Shave biopsy revealed a superficial proliferation of atypical squamous cells emanating from the epidermis with horn cysts. In the reticular to deep dermis, atypical cells formed infiltrative nests and cords arranged in ductal structures within a fibromyxoid stroma.

Squamoid Eccrine Ductal Carcinoma: The Scripps Experience.

Squamoid Eccrine Ductal Carcinoma: The Scripps Experience.

Squamoid Eccrine Ductal Carcinoma.

Squamoid eccrine ductal carcinoma (SEDC) is a rare and under-recognized primary cutaneous tumor with a high risk for local recurrence and metastasis. The tumor has a biphasic histologic appearance consisting of a superficial portion indistinguishable from squamous cell carcinoma (SCC) and a deeper component demonstrating eccrine ductal differentiation. Because of superficial sampling, SEDC often is misdiagnosed as SCC during the initial biopsy. The diagnosis usually is made during complete excision when deeper tissue is sampled. Confirmation of the diagnosis can be achieved by immunohistochemical positivity for carcinoembryonic antigen (CEA), epithelial membrane antigen (EMA), cytokeratin (CK) 5/6, and p63. In this article, we review the clinical and histologic details of 5 patients with SEDC who underwent successful treatment with Mohs micrographic surgery (MMS) at a single institution between November 2018 and May 2020. We also review the histologic patterns that helped distinguish SEDC from SCC upon complete excision. Our findings support the use of MMS as the treatment of choice for SEDC, given that all of the patients we reviewed required more than 1 Mohs stage for complete tumor clearance, and none demonstrated evidence of recurrence or metastasis after a mean follow-up period of 11 months.

Squamoid eccrine ductal carcinoma: A report of two cases

Squamoid eccrine ductal carcinoma: A report of two cases

Squamoid eccrine ductal carcinoma: a case report

Squamoid eccrine ductal carcinoma (SEDC) is a subtype of malignant tumours of skin appendices, showing eccrine and apocrine differentiation. It is a rare tumour and making a histopathological diagnosis is difficult. Our patient was a 79-year-old male, presenting to our hospital with the complaint of a long-term persistent wound in the scalp. An excisional biopsy was performed due to a preliminary diagnosis of a pyogenic granuloma. However, the patient was diagnosed with squamoid eccrine ductal carcinoma. Although an excisional biopsy was performed, the tumour was present on the surgical margins. Consequently, the patient underwent an extended re-excision but the tumour was detected at the surgical margins again. We aimed to present this case as SEDC is a rare tumour.

Squamoid Eccrine Ductal Carcinoma: A Diagnostic

Squamoid Eccrine Ductal Carcinoma: A Diagnostic

Dermoscopy of squamoid eccrine ductal carcinoma: an aid for early diagnosis

AbstractSquamoid eccrine ductal carcinoma is a cutaneous malignancy that originates from the eccrine sweat gland. A 76-year-old woman presented with an asymptomatic papule on her nose that had been present for one year. Dermoscopy showed pseudocysts, irregular linear crown vessels, and yellowish-brown globules surrounded by white halos. This is the first dermoscopic description of squamoid eccrine ductal carcinoma. Studies with more cases are needed to confirm the dermoscopic characterization of this tumor.