Porokarsinom
Özet
Porokarsinom, ekrin kaynaklı malign bir deri eki tümörü olup in situ ve invaziv formları bulunan nadir bir karsinom türüdür. İyi huylu bir poroma kalıntısından transforme olabileceği gibi de novo olarak da gelişebilen bu patoloji, klinik olarak belirgin bir ayırt edici özelliğe sahip olmayıp sıklıkla ülsere nodül, polipoid veya verrüköz plak şeklinde kendini gösterir. Histopatolojik incelemelerde hücresel pleomorfizm, yüksek mitotik aktivite, duktal diferansiyasyon ve berrak hücre değişiklikleri dikkat çekerken; tanısal kesinlik sağlamak adına EMA ve CEA gibi immünohistokimyasal belirteçlerden yararlanılır. Skuamöz hücreli karsinom gibi diğer kutanöz tümörlerle karışabilen porokarsinomun ayırıcı tanısında invaziv büyüme paterninin saptanması kritiktir. Klinik seyir ve prognoz incelendiğinde, yerel nüks ve bölgesel metastaz oranları yaklaşık %20 civarında seyrederken, tümör derinliğinin 7 mm’nin üzerinde olması, yüksek mitotik indeks ve lenfovasküler invazyon varlığı olumsuz prognostik faktörler olarak öne çıkmaktadır.
Porocarcinoma is a rare malignant cutaneous adnexal tumor of eccrine origin that presents in both in situ and invasive forms. The disease can transform from a pre-existing benign poroma remnant or develop de novo, and it lacks distinctive clinical features, typically presenting as an ulcerated nodule, polypoid mass, or verrucous plaque. Histopathological examinations characteristically reveal cellular pleomorphism, high mitotic activity, ductal differentiation, and clear cell changes, while immunohistochemical markers such as EMA and CEA are utilized to support the diagnostic accuracy. Distinguishing porocarcinoma from other cutaneous malignancies, including squamous cell carcinoma, is challenging and heavily relies on identifying an invasive structural growth pattern. Regarding clinical behavior and prognosis, the disease carries local recurrence and regional metastasis rates of approximately 20%, with a tumor depth exceeding 7 mm, high mitotic index, and lymphovascular invasion serving as significant negative predictive parameters.
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