SWEAT GLAND CARCINOMA WITH METASTASES TO THE SKIN - RESPONSE TO 5-FLUOROURACIL CHEMOTHERAPY

A 68-year-old white man presented to the inpatient service at Columbia -Presbyterian Hospital with a chief complaint of a progressively enlar ging tumor of the right infraorbital region for many years and multipl e, pink papulonodules on his head, neck, and trunk, A biopsy specimen of the right infraorbital and back lesions demonstrated an infiltratin g adenocarcinoma with prominent signet ring cells, and small lumen for mation, Results of an extensive workup revealed bone marrow metastases and no evidence of a primary malignancy. We present a case of primary sweat gland carcinoma with metastases to the skin based upon history, clinical presentation, results of physical examination, histopatholog ic examination, immunohistochemical studies, and response to 5-fluorou racil chemotherapy. Due to the rarity of the tumor, the diagnosis is u sually not made until the tumor(s) is invasive. An excellent response to systemic chemotherapy with 5-fluorouracil in metastatic sweat gland carcinoma was noted in this case.