ASOPRSFall Scientific SymposiumSyllabus
166
T13
EccrinePorocarcinomaof theEyelidMasquerading asBasal Cell Carcinoma
LauraGadzalaMD, AllisonBardesMD, JohnNguyenMD, Jennifer Sivak-CallcottMD. Ophthalmology,West Virginia
University,Morgantown,WV, UnitedStates
Introduction:
Eccrine porocarcinoma (EPC) of the eyelid is extremely rare,with only five cases reported.This neoplasm has
the potential for local nodal spread andmetastasis.We report a case of porocarcinoma of the eyelid that presentedwith
features suspicious for basal cell carcinoma (BCCA).
Methods:
Case report and literature review.The clinical presentation, histopathologic characteristics andmanagement
are presented.
Results:
A38 year-oldCaucasian female presentedwith a slowly growing, painless, pruritic, left lower eyelid lesion, present for
8months. She hadmatteringwith occasional bleeding.Visual acuitywas 20/25 right and 20/40 left. Slit lamp examination revealed
a 7.5mm x 3.5mmmarginal lesionwith focal ulceration, notching,madarosis and telangiectasia. She had a left posterior
subcapsular cataract; the rest of the examinationwas normal.The patient underwent full thicknesswedge resectionwith frozen
section control. Histopathology showed numerous EMA-positive ducts consistent with EPC and negativemargins.
EPC is a rare cancer that metastasizes to regional nodes and distant sites. It may arise
as a primary sweat gland tumor ormalignant transformation of an eccrine poroma. Given
the rarity of the disease, there is no standard therapy.Most treatment recommendations
are based on case reports. Our patient had negative surgical margins, but in the literature
20% develop regional nodal involvement and 10% distant metastases despite negative
margins.Mortality in the setting of nodal metastases is nearly 70%, and some advocate
sentinel lymph node biopsy (SLNB).Adjuvant radiation and/or chemotherapy have
variable success. Staging PETCT is recommended to rule out nodal disease and distant
metastases. Of the five cases of eyelid EPC reported, none hadmetastatic disease at the
time of diagnosis, and no deathswere reported.
Conclusions:
EPC is rare, but can occur in the eyelidmasquerading as BCCA. Unlike
BCCA,management includes systemic evaluationwith PETCT and possible SLNB due to
itsmetastatic potential.
References:
1. Chua PY, Comish KS, StenhouseG, Barras CW.A rare case of eccrine
porocarcinoma of the eyelid. SeminOphthalmol. 2013 Feb 27.
2. Jain R, PrabhakarnVC, Huilgol SC, GehlingN, James CL, SelvaD. Eccrine porocarcinoma of the upper eyelid. Ophthal Plast
Reconstr Surg. 2008May-Jun;24(3):221-3.
3. KimY, Scolyer RA, Chia EM, StevenD, Ghabriel R. Eccrine porocarcinoma of the upper eyelid.Australas J Dermatol. 2005
Nov;46(4):278-81.
4. D’Ambrosia RA,WardH, Parry E. Eccrine porocarcinoma of the eyelid treatedwithMohsmicrographic surgery. Darmatol Surg.
2004Apr;30(4 pt 1):570-1.
5. Boynton JR,MarkowitchW Jr. Porocarcinoma of the eyelid. Ophthalmology. 1997Oct;104(10):1626-8.
DetailedProgram
—Thursday,October 16, 2014
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