First Reported Case of Intraparotid Lymph Node Metastasis from Eccrine Porocarcinoma of the Auricular Concha: A Case Report with Long-Term Follow-Up.

IF 2 3区医学 Q2 Dentistry

Journal of Stomatology Oral and Maxillofacial Surgery Pub Date : 2025-09-12 DOI:10.1016/j.jormas.2025.102546

Francesco Chiari, Vitaliano Carusi, Ludovica Borgia, Claudio Donadio Caporale, Pierre Guarino

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Abstract

Background: Eccrine porocarcinoma (EP) is a rare adnexal malignancy with aggressive potential and a predilection for local recurrence and metastasis. The auricular concha is an exceptional site of origin, and intraparotid metastasis has not been previously reported.

Case presentation: We report a 55-year-old immunosuppressed male, kidney transplant recipient, with a slowly enlarging pigmented ulcerated lesion of the left auricular concha. Wide local excision with flap reconstruction confirmed EP on histopathology and immunohistochemistry, with negative margins and no perineural or lymphovascular invasion. After 13 months, a hypermetabolic lesion within the left parotid gland was revealed. Total parotidectomy with ipsilateral modified radical neck dissection confirmed intraparotid lymph node metastasis of EP, with no additional nodal involvement. Adjuvant radiotherapy was delivered.

Conclusions: This is the first documented case of intraparotid lymph node metastasis from head and neck EP, and the metastatic case with the longest disease-free follow-up reported (36 months). The case underscores the diagnostic pitfalls of EP, the need for long-term surveillance, and the importance of systematic parotid evaluation, including ultrasound, in head and neck cases.

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耳甲壳上皮性多孔癌腮腺内淋巴结转移一例：长期随访1例。

背景：内分泌腺孔癌（epp）是一种罕见的具有侵袭性的附件恶性肿瘤，易局部复发和转移。耳甲壳是一个特殊的起源部位，并且在腮腺内转移以前没有报道过。病例介绍：我们报告一个55岁的免疫抑制男性，肾移植接受者，与一个缓慢扩大的左耳甲色素溃疡病变。广泛局部切除及皮瓣重建经组织病理学和免疫组化证实EP，边缘阴性，无周围神经或淋巴血管浸润。13个月后，左侧腮腺出现高代谢病变。全腮腺切除术合并同侧改良根治性颈部清扫证实了EP的腮腺内淋巴结转移，没有额外的淋巴结累及。给予辅助放疗。结论：这是首例记录在案的头颈部EP腮腺内淋巴结转移病例，也是报道的转移病例中最长的无病随访（36个月）。该病例强调了EP的诊断缺陷，长期监测的必要性，以及在头颈部病例中系统腮腺评估（包括超声）的重要性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Stomatology Oral and Maxillofacial Surgery Dentistry-Oral Surgery

CiteScore

2.20

自引率

9.10%

发文量

305

期刊介绍： J Stomatol Oral Maxillofac Surg publishes research papers and techniques - (guest) editorials, original articles, reviews, technical notes, case reports, images, letters to the editor, guidelines - dedicated to enhancing surgical expertise in all fields relevant to oral and maxillofacial surgery: from plastic and reconstructive surgery of the face, oral surgery and medicine, … to dentofacial and maxillofacial orthopedics. Original articles include clinical or laboratory investigations and clinical or equipment reports. Reviews include narrative reviews, systematic reviews and meta-analyses. All manuscripts submitted to the journal are subjected to peer review by international experts, and must: Be written in excellent English, clear and easy to understand, precise and concise; Bring new, interesting, valid information - and improve clinical care or guide future research; Be solely the work of the author(s) stated; Not have been previously published elsewhere and not be under consideration by another journal; Be in accordance with the journal''s Guide for Authors'' instructions: manuscripts that fail to comply with these rules may be returned to the authors without being reviewed. Under no circumstances does the journal guarantee publication before the editorial board makes its final decision. The journal is indexed in the main international databases and is accessible worldwide through the ScienceDirect and ClinicalKey Platforms.