Eccrine poromas are benign, slow-growing tumors originating from the intraepidermal part of the eccrine sweat duct.[1] They occur as pink, red, or flesh-colored, papules or nodules with smooth or verrucous surfaces, typically in palms and soles.[2] They present in middle and elderly aged individuals and have no gender and race predilection. Pigmentation and multifocality are the rare features.[3] Carbon dioxide laser-assisted removal, electrosurgical destruction, and surgical excision with clear margins are the treatment modalities available.[4]
Case Report
A 70-year-old nondiabetic male presented with mass over the medial aspect of his right upper eyelid. The lesion started 6 years back as multiple pea-sized masses, which gradually coalesced to form a single mass, associated with on-and-off foul-smelling discharge from the base of mass. A similar mass concurrently appeared on the medial aspect of his right thigh.
On examination, the pigmented mass measured 3 × 1 cm, was well defined, soft to firm in consistency, nonpulsatile, non-tender, noncompressible, multiloculated, and extended up to the nasal bridge. The lesion on the thigh measured 3 × 2 cm in size, with features similar to the eyelid lesion [Fig. 1].
Figure 1.
Preoperative photograph of the patient
Pus from the mass reported sterile for bacterial and fungal elements. Incisional biopsy revealed intraepidermal eccrine poroma. Histopathology showed the presence of glycogen-filled cuboidal tumor cells with a round basophilic nucleus along with ductal lumina and cystic spaces lined by an eosinophilic, PAS-positive, diastase-resistant cuticle [Fig. 2a and b]. There was prevalence of amylophosphorylase and succinic dehydrogenase enzymes on enzyme histochemical staining, and immunohistochemistry showed poroid cells to be exclusively positive for cytokeratin (CK) 1/5/10/14, CK5/8, and CK14, which are expressed in the outer cells of normal dermal sweat ducts.[5] Excision of the mass was done under local anesthesia as a definitive management. No recurrence reported even after 6 months [Fig. 3].
Figure 2.
(a) Presence of glycogen-filled cuboidal tumor cells with a round basophilic nucleus along with ductal lumina and cystic spaces lined by an eosinophilic, PAS-positive, diastase-resistant cuticle; and (b) broad tongues of uniform epithelium extend into the dermis from the undersurface of the epidermis showing eccrine differentiation (H and E ×100)
Figure 3.
Postoperative photograph after 2 months
Conclusion
Eccrine intraepidermal poroma is a relatively rare benign tumor of the eyelid. Complete excision of the tumor is curative.
Declaration of patient consent
The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.
Financial support and sponsorship
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Conflicts of interest
There are no conflicts of interest.
Acknowledgments
Manuscript has been read and approved by all the authors and the requirements for authorship as stated earlier in this document have been met. Each author believes that the manuscript represents honest work.
References
- 1.Abenoza P, Ackerman AB. Poromas. Neoplasms with eccrine differentiation. Philadelphia: Lea & Febiger; 1990. pp. 113–85. [Google Scholar]
- 2.Goldman P, Pinkus H, Rogin JR. Eccrine poroma; tumors exhibiting features of the epidermal sweat duct unit. AMA Arch Derm. 1956;74:511–21. [PubMed] [Google Scholar]
- 3.Kassuga LE, Jeunon T, Sousa MA, Campos-do-Carmo G. Pigmented poroma with unusual location and dermatoscopic features. Dermatol Pract Concept. 2012;2:0203a07. doi: 10.5826/dpc.0203a07. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 4.Rabady DZ, Carlson JA, Meyer DR. Poroma of the eyelid. Ophthalmic Plast Reconstr Surg. 2008;24:63–5. doi: 10.1097/IOP.0b013e31816102c8. [DOI] [PubMed] [Google Scholar]
- 5.Ahmed T, Priore J, Seykora J. Tumours of the epidermal appendages. In: Elder D, editor. Lever's Histopathology of the Skin. 10th ed. Philadelphia: Lippincott; 2009. pp. 885–6. [Google Scholar]