A case of eccrine porocarcinoma characterized by a progressive increase in the level of Ki-67 index: case report and review of literature - PubMed (original) (raw)

Review

A case of eccrine porocarcinoma characterized by a progressive increase in the level of Ki-67 index: case report and review of literature

Jie Shen et al. BMC Surg. 2019.

Abstract

Background: Eccrine porocarcinoma is an extremely rare skin adnexal malignant neoplasia with highly invasive and metastatic potential. We report an additional case of eccrine porocarcinoma with intracranial metastases. This case is characterized by a complete record of the progress of eccrine porocarcinoma, its immunohistochemistry after three operations showed a progressive increase in the level of Ki-67 index.

Case presentation: We herein report a case of a 37-year-old-male with eccrine carcinoma occurring on the left posterior occipital scalp which invaded the skull and dura, presenting with progressive headache. This patient has performed three surgeries in total. During the last hospitalization, he underwent an extended surgical resection, lymphadenectomy, myocutaneous flap transplantation and vascular anastomosis in our institution. After surgery, he was treating with radiotherapy at 200 Gray in 12 fractions. But one year after the operation, he developed chest tightness, imaging examination and biopsy puncture revealed pulmonary metastasis.

Conclusion: Intracranial metastasis of eccrine porocarcinoma is a late event with poor prognosis. This case emphases on that progressively increased level of Ki-67 index may predict more chance to occur the intracranial metastasis of scalp eccrine porocarcinoma, long-term follow-up and appropriately dense follow-up interval is necessary.

Keywords: Dura; Eccrine porocarcinoma; Hidradenocarcinoma; Invasion; Ki-67; Metastasis; Scalp; Sweat gland carcinoma.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1

(a, b) A circular abnormal signal is seen on the left occipital scalp. The border of lesion is clear and its size is about 3.3 × 1.8 cm, the adjacent bone is thin. (c,d) There are enhanced abnormal signals on the left occipital skin, subcutaneous and adjacent meninges. (e,f) Postoperative examination of MRI image showing cranial screw fixation, no recurrence

Fig. 2

Left occipital poorly differentiated carcinoma after secondary resection: left occipital are scalp and subcutaneous soft tissue density irregularity, with left occipital bone destruction, FDG metabolism increased, consider tumor recurrence

Fig. 3

(a) image of the surgical area before the last operation. (b) the postoperative image of transferred skin flaps

Fig. 4

(a, b) Histopathology revealed cells contained atypical cell nuclei with conspicuous nucleoli, and small amount of eosinophilic cytoplasm. Mitotic figures and apoptotic cells were existed in the lesion (original magnification × 100 or 400, H&E). (c, d, e, f, g, h) Immunohistochemically, the lesional cells were positive when stained with antibodies against cytokeratin 5/6, Ki-67, and PAS, highlighted scattered ductal structures throughout the neoplasm

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A case of eccrine porocarcinoma characterized by a progressive increase in the level of Ki-67 index: case report and review of literature - PubMed (original) (raw)