Eccrine porocarcinoma (EPC) is a rare cutaneous neoplasm that grows slowly over a long period of time but often experiences an accelerated growth phase. This malignant tumor may arise denovo or evolve from a pre-existing benign eccrine poroma. Histologic evaluation demonstrates anaplastic cells involving the epidermis and infiltrating the dermis. Metastasis to regional lymph nodes distally occurs in a significant number of cases. Treatment modalities have included standard excision, Mohs micrographic surgery (MMS), chemotherapy, and radiation therapy. Recently sentinel lymph node biopsy has begun to be investigated as a staging tool. The literature on EPC is reviewed with attention paid to which of the various therapeutic options offers a clear advantage over the others. MMS affords the greatest likelihood of clear margins and cure in absence of regional and distant metastases.

We present the case of an immunocompromised patient treated for microcystic adnexal carcinoma with Mohs micrographic surgery who proceeded to develop local metastasis in transit.

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