Abstract

PC is a rare skin cancer originating from eccrine glands. It mostly affects elderly population. The most common site is extremities. Clinically, it presents as verrucous plaques or polypoid growths that easily bleeds with minor trauma. Histopathologic examination shows nested small basaloid cells with prominent clear cell changes, necrosis, squamous and sarcomatoid differentiation. We present a case in association with multiple skin cancers and EMPD. A 72 year old man medical history significant for BCC, Bowen’s disease and squamous cell carcinoma, presented with raised skin colored lesions on the nose, forehead, cheeks. Histopathologic examination of nose lesion revealed variably sized dermal nodules consist of cells with poroid morphology with cuticular cells and a focus of ductal differentiation. Cytologic atypia, pyknosis and mitosis was prominent. Neoplastic cells showed positive p40 and patchy AE1AE3, and negative CK7 and SOX10 staining consistent with PC. Adjacent to PC, there was nested basaloid cells with high mitosis, consistent with superficial and nodular BCC. Also, atypical cells that have abundant pale or vacuolated cytoplasm within the epidermis with multifocal actinic keratosis and dermal nodular and cystic tumor was noted. Atypical cells showed positive staining with CK7 and BER EP4, that is consistent with EMPD. PC is a rare malignant neoplasm without well-known etiology. Transformation from poroma and nevus sebaceous has been implicated. We don’t know the exact correlation EMPD and BCC played in this case. However, same time and location arises the possibility that PC may be arising from a preexisting EMPD or BCC. This is the first case of PC that coexists with BCC and EMPD in the literature. Even though, this can be by chance, it deserves further investigation.

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