Treatment of Metastatic Sweat Gland Carcinomas: Response in Two Cases

Sweat gland carcinomas are a rare group of tumors with the potential of destructing local tissue infiltration as well as regional and distant metastasis. Due to the limited availability of reference from the literature, the management of sweat gland carcinomas is both complex and cumbersome. Sweat gland carcinomas can be divided into eccrine and apocrine categories and occur primarily in adult patients, with a peak incidence during the fifth and sixth decades [1-2]. The majority of sweat gland carcinomas occur in the genital skin and perineum, followed by the trunk, head, neck and lower extremities. Regional and distant lymph node metastases frequently occur in a certain number of patients, but visceral metastases are seldom found. The metastasis sites mainly include lymph nodes, lungs and bone [3-5]. According to the available literature, radical surgical excision is the prior and standard treatment with the clearance of draining lymph nodes [6]. Some chemotherapeutic drugs, such as fluoropyrimidines, taxanes and cisplatin, have been reported to be active agents for metastatic sweat gland carcinomas [2,7-8]. However, the effect of adjuvant chemotherapy and radiotherapy remain elusive, and classical standards of diagnosis and therapy are still not clarified. Here, we report two cases of metastatic sweat gland carcinomas. In one case, the remission of nearly 6 months was achieved through chemotherapy of GP regimen; while in another case, the size of draining axillary lymph nodes was effectively controlled by oral administration of tamoxifen.