Porocarcinoma: an epidemiological, clinical, and dermoscopic 20‐year study

Abstract

Background Porocarcinoma (PC) is a rare cutaneous adnexal tumor with a variable metastatic potential. Given the paucity of data, guidelines and specific recommendations for PC are not yet well‐established. In this study, we evaluate the disease‐specific characteristics and outcome of this rare and often underestimated tumor. Materials and method A retrospective study of the epidemiological, clinical, and dermoscopic characteristics among cases of histopathologically diagnosed PC, collected from the database of two skin cancer clinics in Italy (Firenze, Pistoia) from 2000 to 2020, was conducted. Results Among the 52 patients with 53 tumors, 31 were men (59.6%) and 21 were women (40.4%) with an age range of 49–96 years (median age 82 years). The most common locations were the head/neck region in men (34% in men vs. 17% in women) and the lower limb in women (17% in women vs. 9% in men). Forty‐eight cases (91%) underwent local excision. Of these patients, two (4%) experienced local recurrence, and one (2%) developed a second PC on a different anatomical site 1 month after the primary tumor's excision. Lymph node metastases were present in three cases (6%). Two of them have been treated surgically with adjuvant radiotherapy (both are disease‐free after a 2‐year follow‐up period), whereas the third case developed visceral metastases followed by PC‐related death. Conclusions This study, with 52 patients with 53 tumors covering a follow‐up period of more than 5 years, shows a less aggressive behavior of PC with 4% local recurrence, 6% nodal metastases, and 2% mortality.

Diagnosis and Management of Porocarcinoma

“…De Giorgi et al reported that the affected sites of PC may depend on the sex, based on a study of 52 PC cases (31 male and 21 female). [ 17 ] Their study revealed that the most involved site was the head and neck (47%), which was more common in males than in females (34% males vs. 17% females). The lower extremities were the most common site among female cases (17% females vs. 9% males).…”

“…As for the recurrence rates, a retrospective study revealed that 6 of 52 cases (11.5%) showed recurrence of PC tumors within 5 years [ 17 ]. Since the reported recurrence rates vary from study to study, Belin et al proposed an algorithm using prognostic histological factors that could guide surgical procedures [ 38 ].…”

Adjuvant radiotherapy in the management of porocarcinoma with lymphatic micrometastasis

“…The rates of local recurrence, regional recurrence, and distant metastasis are around 17%, 19%, and 11% after primary therapy, respectively [8]. Wide local excision is the preferred approach for definitive treatment, but Mohs micrographic surgery is also used with increasing frequency, especially in the head and neck region [9,10].…”

Gene fusions in poroma, porocarcinoma and related adnexal skin tumours: An update

“…There are discrepancies regarding the prognosis of porocarcinoma, with reports of a 10‐year overall survival estimated at 55%, 9 while others have reported an excellent outcome at a localised stage 3,6,7,10 . The rate of regional lymph node metastasis ranges from 19 to 57%, depending on the study 3,38 .…”

“…Regarding the prognosis of porocarcinoma, data are conflicting between the early and most recent series 3,6–10 . Low‐grade porocarcinomas may raise a differential diagnosis with poromas, whereas high‐grade tumours must be distinguished from other poorly differentiated carcinomas, especially squamous cell carcinoma 3,11 .…”