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Metastatic sweat gland adenocarcinoma: A clinico-pathological dilemma.

- World J Surg Oncol (2003)

Bottom Line: Liver, lung and bones are the distant sites of metastasis with fatal results.Surgery in the form of wide local excision and lymph node dissection is the mainstay of treatment.Chemotherapy and/or radiotherapy has limited role.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Surgery, Vardhman Mahavir Medical College & Safdarjang Hospital, New Delhi 110023 India. chintamani7@rediffmail.com

ABSTRACT
BACKGROUND: Sweat gland adenocarcinoma is a rare malignancy with high metastatic potential seen more commonly in later years of life. Scalp is the most common site of occurrence and it usually spreads to lymph nodes. Liver, lung and bones are the distant sites of metastasis with fatal results. The differentiation between apocrine and eccrine metastatic sweat gland carcinoma is often difficult. The criteria's are inadequate to be of any practical utility. CASE REPORT: Two cases of metastatic sweat gland adenocarcinoma (one of eccrine and the other one of apocrine origin) are being reported on account of the rarity and different outcome. CONCLUSION: Sweat gland carcinomas are rare cancers with a poor prognosis often presenting as histological surprises. Surgery in the form of wide local excision and lymph node dissection is the mainstay of treatment. Chemotherapy and/or radiotherapy has limited role.

No MeSH data available.


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Photomicrograph of sweat gland carcinoma (Hematoxyllin and eosin × 10) Figure 2A: Showing glandular pattern with dermal invasion ((Hematoxyllin and eosin × 10) Figure 2B: Diastase sensitive, PAS positive tumor cells (PAS × 10)
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Figure 2: Photomicrograph of sweat gland carcinoma (Hematoxyllin and eosin × 10) Figure 2A: Showing glandular pattern with dermal invasion ((Hematoxyllin and eosin × 10) Figure 2B: Diastase sensitive, PAS positive tumor cells (PAS × 10)

Mentions: Hematological and biochemical investigations were within normal limits. Chest roentgenogram showed healed tubercular lesion in right apical area. A contrast enhanced computerized tomographic scan (CECT) of the chest and fiber optic bronchoscopy was carried out which did not reveal any significant pathology except healed fibro cavitatory lesion in the right apex. Ultrasound examination of both the breasts, and abdomen was essentially normal. Fine needle aspiration cytology (FNAC) from the axillary lymph node revealed metastatic adenocarcinoma. Excision biopsy of the lymph node and suspected primary skin lesion was performed which revealed metastatic sweat gland adenocarcinoma with solid and glandular pattern (figure 2). The tumor cells were Periodic Acid Schiff (PAS) positive, diastase sensitive and were estrogen receptor negative. A diagnosis of sweat gland adenocarcinoma, probably of eccrine origin was made. An axillary lymph node dissection along with excision of the previous scar was carried out. While raising the upper skin flap two-satellite cutaneous nodules each measuring, 2–3 mm in diameter, were found and were excised en bloc. Histological examination of the resected specimen confirmed the diagnosis of metastatic sweat gland adenocarcinoma of eccrine origin. Patient had an uneventful recovery and is disease free after two years of follow-up.


Metastatic sweat gland adenocarcinoma: A clinico-pathological dilemma.

- World J Surg Oncol (2003)

Photomicrograph of sweat gland carcinoma (Hematoxyllin and eosin × 10) Figure 2A: Showing glandular pattern with dermal invasion ((Hematoxyllin and eosin × 10) Figure 2B: Diastase sensitive, PAS positive tumor cells (PAS × 10)
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC184447&req=5

Figure 2: Photomicrograph of sweat gland carcinoma (Hematoxyllin and eosin × 10) Figure 2A: Showing glandular pattern with dermal invasion ((Hematoxyllin and eosin × 10) Figure 2B: Diastase sensitive, PAS positive tumor cells (PAS × 10)
Mentions: Hematological and biochemical investigations were within normal limits. Chest roentgenogram showed healed tubercular lesion in right apical area. A contrast enhanced computerized tomographic scan (CECT) of the chest and fiber optic bronchoscopy was carried out which did not reveal any significant pathology except healed fibro cavitatory lesion in the right apex. Ultrasound examination of both the breasts, and abdomen was essentially normal. Fine needle aspiration cytology (FNAC) from the axillary lymph node revealed metastatic adenocarcinoma. Excision biopsy of the lymph node and suspected primary skin lesion was performed which revealed metastatic sweat gland adenocarcinoma with solid and glandular pattern (figure 2). The tumor cells were Periodic Acid Schiff (PAS) positive, diastase sensitive and were estrogen receptor negative. A diagnosis of sweat gland adenocarcinoma, probably of eccrine origin was made. An axillary lymph node dissection along with excision of the previous scar was carried out. While raising the upper skin flap two-satellite cutaneous nodules each measuring, 2–3 mm in diameter, were found and were excised en bloc. Histological examination of the resected specimen confirmed the diagnosis of metastatic sweat gland adenocarcinoma of eccrine origin. Patient had an uneventful recovery and is disease free after two years of follow-up.

Bottom Line: Liver, lung and bones are the distant sites of metastasis with fatal results.Surgery in the form of wide local excision and lymph node dissection is the mainstay of treatment.Chemotherapy and/or radiotherapy has limited role.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Surgery, Vardhman Mahavir Medical College & Safdarjang Hospital, New Delhi 110023 India. chintamani7@rediffmail.com

ABSTRACT
BACKGROUND: Sweat gland adenocarcinoma is a rare malignancy with high metastatic potential seen more commonly in later years of life. Scalp is the most common site of occurrence and it usually spreads to lymph nodes. Liver, lung and bones are the distant sites of metastasis with fatal results. The differentiation between apocrine and eccrine metastatic sweat gland carcinoma is often difficult. The criteria's are inadequate to be of any practical utility. CASE REPORT: Two cases of metastatic sweat gland adenocarcinoma (one of eccrine and the other one of apocrine origin) are being reported on account of the rarity and different outcome. CONCLUSION: Sweat gland carcinomas are rare cancers with a poor prognosis often presenting as histological surprises. Surgery in the form of wide local excision and lymph node dissection is the mainstay of treatment. Chemotherapy and/or radiotherapy has limited role.

No MeSH data available.


Related in: MedlinePlus