Abstract

An eccrine poroma is a benign cutaneous adnexal tumor of the acrosyringium, most commonly found on acral surfaces. An eccrine porocarcinoma is a rare malignant counterpart that may develop from a pre-existing eccrine poroma or arise independently. Eccrine porocarcinoma has a high metastatic potential and frequently recurs despite aggressive treatment. Unusual sites for both entities have been reported in the literature after histologic confirmation. Herein, we present a rare case of eccrine poroma with atypia located on the nipple in a 79-year-old man. The patient described rapid evolution of a pre-existing small growth that had previously been stable for decades. The growth was asymptomatic but had recently begun to bleed from minimal trauma. On skin examination, the left areola displayed an exophytic flesh to pink colored superficially ulcerated papule. Biopsy was performed and revealed an eccrine poroma with overall benign architecture but with numerous mitotic figures and areas of focal necrosis, transected at the deep margin. Given the concerning clinical history, proliferative nature of the initial specimen, and potential for malignant transformation, surgical management was recommended, and clear margins were attained upon re-excision. Overall, this unique case highlights the broad spectrum of clinicopathologic presentations of eccrine neoplasms.

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