BACKGROUND. Malignant metastatic eccrine poroma is a very rare cutaneo
us neoplasm, and consequently the references in the literature regardi
ng the treatment of this tumor, known also as porocarcinoma, are very
pool. OBJECTIVE. TO call attention to a new, therapeutic protocol in t
he treatment of metastatic porocarcinoma, as well as to underline an a
ntineoplastic efficacy of vitamin A analogues. METHODS. The results ar
e presented on the basis of the clinical case of a malignant eccrine p
oroma with metastatic regional lymph nodes. RESULTS. With our new chem
otherapeutic protocol, arrest of the metastatic progression was achiev
ed after 3 months and the remission was maintained until the 10th mont
h of therapy. CONCLUSIONS. A new chemotherapy protocol consisting of i
sotretinoin and interferon alpha has confirmed the advantages of polyc
hemotherapy in the treatment of metastatic malignant eccrine poroma. O
n the basis of the considerably long, although incomplete, remission w
ith good drug tolerance in spite of the high doses used as well as the
undoubtedly major antineoplastic strength of the latest generation of
synthetic retinoids, we feel that these findings could be a good star
ting point for further experimental verifications of the therapy of th
is aggressive cutaneous neoplasm. (C) 1997 by the American Society for
Dermatologic Surgery, Inc.