A unique case of eccrine porocarcinoma with pulmonary lymphangitis and pericardial involvement: Biological characterization and clinical aggressiveness

A unique case of eccrine porocarcinoma with pulmonary lymphangitis and peri cardial involvement is reported. The clinical course was aggressive, leadin g to the death of the patient a few months after diagnosis, Certain patholo gial markers of clinical aggressiveness were retrospectively investigated: p53 and Ki-67 expression were determined by means of immunohistochemistry. Angiogenesis was assessed by determination of intratumor microvessel densit y at the vascular 'hot spot' with the anti-CD34 monoclonal antibody and qua ntitative analysis using computerized image analyzer. Both primary tumor an d metastatic lymph node presented immunostaining for p53 and Ki-67, with a higher deg ree of vascularization in the secondary lesions compared to the primary tumor. Our findings suggest a correlation between tumor vasculariza tion and clinicopathological parameters of aggressiveness in malignant eccr ine porocarcinoma. Taking into account the disappointing results of current treatments for metastatic eccrine porocarcinoma, the assay of microvessel density may be helpful in selecting the patients of high risk for recurrenc e or death who may benefit of anti-angiogenic therapies. Copyright (C) 2000 S. Karger AG, Basel.