Journal of Clinical & Experimental Dermatology Research
Open Access
ISSN: 2155-9554
+44 1478 350008
ISSN: 2155-9554
+44 1478 350008
Chen Qiping and Tan Wee Ping Melissa
National Skin Centre, Singapore
Posters & Accepted Abstracts: J Clin Exp Dermatol Res
We report a case of a 71-year-old Chinese male who presented with a large ulcerating nodular plaque on the scalp, which was rapid progressing. Histology from incisional skin biopsy showed typical features of squamoid eccrine ductal carcinoma (SEDC) with infiltrative pattern and deep perineural invasion. Further CT scan of brain showed infiltrative ulcerating enhancing soft tissue mass over the left parietal and temporal scalp without cervical lymph nodes metastasis. Interestingly, this patient had history of nodular plaque on the same region of the scalp over a decade ago for which he underwent wide excision. Although the histology report then was basosquamous carcinoma, we believed it was most likely SEDC and real pathology was missed out due to its extreme rarity and diagnostic challenge in that era. Therefore, our patient was likely to have recurrent SEDC. SEDC is an extremely rare variant of cutaneous eccrine tumors that usually occurs on head and neck. Its histology shows both squamous and adnexal ductal characteristics. It has strong predilection for local recurrence as well as a metastatic potential. Due to its rarity, there is no consensus on the treatment modality. Surgical excision is usually accepted as the primary curative modality. Mohs micrographic surgery has been shown as an effective therapeutic modality in some case reports. Radiation therapy can be considered for our case in view of perineural invasion, size of the lesion and high risk for general anesthesia during surgery due to his other underling medical conditions.
Email: qpchen@nsc.com.sg