Eccrine Porocarcinoma presenting as an abdominal wall mass in a patient with ulcerative colitis—A rare case report

• Eccrine Porocarcinoma (EPC) is rare. It seldom occurs in the early 20s, or arises in the abdominal wall
• EPC is easily misdiagnosed due to lack of specific morphological features. Clinical picture usually consists of a painless nodule or papule
• Definitive diagnosis is achieved by histopathological examination
• Early definitive surgical excision with wide tumor free margins leads excellent results. Risk of local recurrence is about 20%
• High index of suspicion for EPC should be maintained in patients with cystic abdominal wall masses, especially in case of ulceration or discharge

IntroductionEccrine porocarcinoma (EPC) is a rare malignancy of eccrine sweat glands. It is often seen during the sixth to eighth decades of life. We report the first case of eccrine porocarcinoma arising on the abdomen of a 21-year-old patient with ulcerative colitis.Case presentationA 21-Year-old female presented to emergency department with a one month history of an enlarging mass over left lower abdomen. Abdominal examination revealed a slightly erythematous, nodular and non-mobile firm mass in left lower quadrant. There was superficial ulceration with slight serous discharge. CT scan of the abdomen and pelvis with contrast revealed a superficial cystic lesion over the anterior abdominal wall, provisionally diagnosed as sebaceous cyst. Incision and drainage were performed and on follow-up, no signs of healing were observed and the patient subsequently underwent surgical excision. Histopathological examination revealed an eccrine porocarcinoma.DiscussionEPC is a rare and aggressive tumor. It may occur de novo or as a result of malignant transformation of an eccrine poroma. A long period of clinical history is often encountered. It usually occurs on the lower extremities followed by the, trunk, head and neck, and upper extremities. The clinical picture usually consists of a painless nodule or papule. Treatment is wide local excision. No strong evidence exists for adjuvant therapy. The risk of local recurrence is about 20%.ConclusionHigh index of suspicion is required for diagnosis of EPC. Early diagnosis is achieved by histopathological examination and early definitive surgical excision leads to excellent results.