Squamoid Eccrine Ductal Carcinoma: Case Series of a Rare, Potentially Aggressive Skin Cancer Associated With Immunosuppression.
Xiang Li Tan, Pooja Patel, Jeva Cernova et al.
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Case in brief
In this single-centre retrospective series, 10 patients with squamoid eccrine ductal carcinoma (SEDC) were identified; 9 were immunocompromised, including 6 solid-organ transplant recipients and 3 patients with haematologic malignancy. SEDC was not initially diagnosed in any of the 4 patients who underwent incisional biopsy; diagnosis followed complete excision. Locoregional recurrence occurred in 8 patients and distant metastasis in 2. All underwent surgical excision; 60% received postoperative radiotherapy for close or incomplete margins or metastasis, and 20% underwent lymphadenectomy or parotidectomy.
What made this case unusual
The series found immunosuppression in 9 of 10 patients, a higher proportion than the approximately 20% previously reported in the abstract. Superficial incisional sampling also failed to establish the diagnosis in all 4 biopsied cases.
Diagnostic / clinical pearl
SEDC’s biphasic histology may be missed in superficial biopsies and mistaken for Bowen disease or cutaneous squamous cell carcinoma; adequate sampling and clinicopathologic correlation are important.
Why it matters
The authors suggest the association between SEDC and immunosuppression may have been underestimated; the series also documents frequent locoregional recurrence and distant metastasis.