Squamoid eccrine ductal carcinoma of the scalp

Chan, Huan; Howard, Vicki; Moir, D.H.; Dyall‐Smith, Delwyn

doi:10.1111/ajd.12309

Cited by 7 publications

(5 citation statements)

References 13 publications

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“…Two of these reported cases were in the setting of underlying chronic lymphocytic leukemia, 2 in individuals with a history of organ transplant, and 1 treated with azathioprine for myasthenia gravis. 2,4,10,12,13 Our chart review supported this correlation, as all 5 patients had a medical history potentially consistent with being in an immunocompromised state (Table ). Notably, patient 5 represents a unique case of SEDC occurring in the setting of HIV.…”

Section: Commentmentioning

confidence: 54%

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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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Section: Commentmentioning

confidence: 54%

“…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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“…Although there have been no cases with both EMA and CEA stains being negative, negative expression of one of these stains alone does not exclude SEDC, as reported in four cases [13,[18][19][20].…”

Section: Discussionmentioning

confidence: 84%

Squamoid eccrine ductal carcinoma: clinical, histological and immunohistochemical features

Chan,

Sriharan,

LeBlanc

et al. 2024

DOJ

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“…While the superficial areas mostly show a squamous differentiation, syringomalike basaloid, angulated, and tubular structures characterised with a more infiltrative pattern are mostly observed in the deeper parts [1][2][3][4][5][6][7][8]. Therefore, superficial biopsies may lead to a misdiagnosis of SCC as the biopsy specimen will most likely be composed of tissues showing a squamous differentiation [2,9,10]. The differential diagnosis includes SCC, metastatic carcinoma, microcystic carcinoma with squamous differentiation, porocarcinoma with squamous differentiation, Merkel cell carcinoma, and benign neoplasms [1,11].…”

Section: Discussionmentioning

confidence: 99%

Squamoid eccrine ductal carcinoma: a case report

Bayramoğlu

Ünal

2020

The European Research Journal

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Squamoid eccrine ductal carcinoma (SEDC) is a subtype of malignant tumours of skin appendices, showing eccrine and apocrine differentiation. It is a rare tumour and making a histopathological diagnosis is difficult. Our patient was a 79-year-old male, presenting to our hospital with the complaint of a long-term persistent wound in the scalp. An excisional biopsy was performed due to a preliminary diagnosis of a pyogenic granuloma. However, the patient was diagnosed with squamoid eccrine ductal carcinoma. Although an excisional biopsy was performed, the tumour was present on the surgical margins. Consequently, the patient underwent an extended re-excision but the tumour was detected at the surgical margins again. We aimed to present this case as SEDC is a rare tumour.

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Squamoid eccrine ductal carcinoma of the scalp

Abstract: An 85-year-old man presented with an ulcerated pruritic nodule on the scalp. Histology of a deep curette specimen showed the typical features of a squamoid eccrine ductal carcinoma: superficial squamous differentiation and deep ductal structures.

Cited by 7 publications

References 13 publications

Squamoid Eccrine Ductal Carcinoma

Squamoid Eccrine Ductal Carcinoma

Squamoid eccrine ductal carcinoma: clinical, histological and immunohistochemical features

Squamoid eccrine ductal carcinoma: a case report

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