Squamoid Eccrine Ductal Carcinoma: An Aggressive Mimicker of Squamous Cell Carcinoma

Mckissack, Sterling S; Wohltmann, Wendi; Dalton, Scott R.; Miletta, Nathanial R

doi:10.1097/dad.0000000000001214

Cited by 10 publications

(17 citation statements)

References 6 publications

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“…6,11 The immunohistochemical profile is also consistent with that of several prior studies. 11,12 Furthermore, cytologic atypia and perineural invasion are noted in this case. In the largest published series of SEDC (30 cases), these tumors displayed moderate-to-severe atypia, and 27% featured perineural invasion.…”

Section: Discussionmentioning

confidence: 55%

“…Histologically, porocarcinomas may display squamous differentiation but do not typically demonstrate the biphasic pattern seen in SEDC. 12 Microcystic adnexal carcinomas also can exhibit squamoid features but are additionally characterized by keratinous cysts, which are not seen in SEDC. 9,12 Although syringoid eccrine carcinomas are similar to SEDC in that they display a deep infiltrative growth pattern of ducts, they lack squamous differentiation.…”

Section: Discussionmentioning

confidence: 99%

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Squamoid Eccrine Ductal Carcinoma of the Eyelid: Clinicopathologic Correlation of a Case

Patel

Alabiad

Wick³

et al. 2022

Ophthalmic Plastic &Amp; Reconstructive Surgery

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Squamoid eccrine ductal carcinoma (SEDC) is a rare cutaneous neoplasm that often manifests as a plaque or nodule in sun-exposed areas of older patients. Herein, the authors report the first case of SEDC in the eyelid. A 76-year-old man presented with a 2.5 × 1.5 mm area of left upper eyelid erythema, thickening, ulceration, and scaling with madarosis superotemporally just above the lash line. Full-thickness wedge biopsy demonstrated irregular epithelial tubules with nuclear atypia and focal squamous differentiation, consistent with SEDC. The patient underwent Mohs resection and has had no recurrence approximately 27 months after surgical removal. The authors present this case to raise awareness of SEDC to ophthalmologists as all previous cases have been described in the nonophthalmic literature. A full-thickness biopsy is recommended to avoid misdiagnosing SEDC as squamous cell carcinoma (SCC), a less aggressive tumor. With greater awareness, there may be increased recognition of this likely underreported, more malignant entity.

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Section: Discussionmentioning

confidence: 55%

Section: Discussionmentioning

confidence: 99%

Squamoid Eccrine Ductal Carcinoma of the Eyelid: Clinicopathologic Correlation of a Case

Patel

Alabiad

Wick³

et al. 2022

Ophthalmic Plastic &Amp; Reconstructive Surgery

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“…Our review yielded 56 cases of SEDC. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19] The mean age of patients with SEDC was 72 years. The number of male and female cases was 52% (29/56) and 48% (27/56), respectively.…”

Section: Literature Reviewmentioning

confidence: 99%

Squamoid Eccrine Ductal Carcinoma

Svoboda¹,

Rush²,

Garofola³

et al. 2021

Cutis

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Squamoid eccrine ductal carcinoma (SEDC) is a rare and underrecognized primary cutaneous tumor with a high risk for local recurrence and metastasis. The tumor has a biphasic histologic appearance consisting of a superficial portion indistinguishable from squamous cell carcinoma (SCC) and a deeper component demonstrating eccrine ductal differentiation. Because of superficial sampling, SEDC often is misdiagnosed as SCC during the initial biopsy. The diagnosis usually is made during complete excision when deeper tissue is sampled. Confirmation of the diagnosis can be achieved by immunohistochemical positivity for carcinoembryonic antigen (CEA), epithelial membrane antigen (EMA), cytokeratin (CK) 5/6, and p63. In this article, we review the clinical and histologic details of 5 patients with SEDC who underwent successful treatment with Mohs micrographic surgery (MMS) at a single institution between November 2018 and May 2020. We also review the histologic patterns that helped distinguish SEDC from SCC upon complete excision. Our findings support the use of MMS as the treatment of choice for SEDC, given that all of the patients we reviewed required more than 1 Mohs stage for complete tumor clearance, and none demonstrated evidence of recurrence or metastasis after a mean follow-up period of 11 months.Cutis. 2021;107:E5-E9. Squamoid eccrine ductal carcinoma (SEDC) is an aggressive underrecognized cutaneous malignancy of unknown etiology. 1 It is most likely to occur in sun-exposed areas of the body, most commonly the head and neck. Risk factors include male sex, increased age, and chronic immunosuppression. [1][2][3][4] Current reports suggest that SEDC is likely a high-grade subtype of squamous cell carcinoma (SCC) with a high risk for local recurrence (25%) and metastasis (13%). 1,3,5,6 There are as few as 56 cases of SEDC reported in the literature; however, the number of cases may be closer to 100 due to SEDC being classified as either adenosquamous carcinoma of the skin or ductal eccrine carcinoma with squamous differentiation. 1 Clinically, SEDC mimics keratinocyte carcinomas. Histologically, SEDC is biphasic, with a superficial portion resembling well-differentiated SCC and a deeply invasive portion having infiltrative irregular cords with ductal differentiation. Perineural invasion (PNI) frequently is present. Multiple connections to the overlying epidermis also can be seen, serving as a subtle clue to the diagnosis on broad superficial specimens. [1][2][3] Due to superficial sampling, approximately 50% of reported cases are misdiagnosed as SCC during the initial biopsy. 4 The diagnosis of SEDC often is made during complete excision when deeper tissue is sampled. Establishing an accurate diagnosis is important given the more aggressive nature of SEDC compared with SCC and its proclivity for PNI. 1,3,6 The purpose of this review is to increase awareness of this underrecognized entity and describe the histologic findings that help distinguish SEDC from SCC.

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“…Histologically, squamoid eccrine ductal carcinoma exhibits a biphasic growth pattern. 14 Well-differentiated squamous dysplasia transitions to carcinoma with eccrine duct formation as the tumor percolates deep into the dermis (Figure 4). As a result, superficial skin biopsies often lead to an incorrect diagnosis.…”

mentioning

confidence: 99%

“…Pseudoepitheliomatous hyperplasia is a benign histologic reaction that can result from trauma, chronic inflammation (ie, pyoderma gangrenosum), tattoo placement, underlying neoplasia or fungal infection, or a spider bite reaction. 14,15 It most commonly is seen as a well-demarcated nodule or plaque associated with scaling or crusting. Papules vary in size from less than 1 cm to several centimeters.…”

mentioning

confidence: 99%

Rapidly Growing Nodule Within a Previously Radiated Area of the Scalp

Thompson¹

2023

Cutis

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An 84-year-old man with a history of nonmelanoma skin cancer presented to our clinic with a 1.6×1.5-cm exophytic lesion on the left posterior parietal scalp. The lesion nearly doubled in size over the last 4 months. The patient received radiation therapy in this area for the treatment of basal cell carcinoma 7 years prior to presentation. A shave biopsy was performed. THE BEST DIAGNOSIS IS:a. angiosarcoma b. bacillary angiomatosis c. deep fungal infection with pseudoepitheliomatous hyperplasia d. pseudoangiomatous squamous cell carcinoma e. squamoid eccrine ductal carcinoma

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Squamoid Eccrine Ductal Carcinoma: An Aggressive Mimicker of Squamous Cell Carcinoma

Cited by 10 publications

References 6 publications

Squamoid Eccrine Ductal Carcinoma of the Eyelid: Clinicopathologic Correlation of a Case

Squamoid Eccrine Ductal Carcinoma of the Eyelid: Clinicopathologic Correlation of a Case

Squamoid Eccrine Ductal Carcinoma

Rapidly Growing Nodule Within a Previously Radiated Area of the Scalp

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