Metastatic malignant acrospiroma of the hand

• Published in: European journal of surgical oncology Vol. 27; no. 4; pp. 431 - 435
• Main Authors: Görtler, I, Köppl, H, Stark, G.B, Horch, R.E
• Format: Journal Article
• Language: English
• Published: Amsterdam Elsevier Ltd 01.06.2001; Elsevier
• Subjects: acrospiroma; Adult; Biological and medical sciences; Dermatology; Diagnostic Errors; Fatal Outcome; Hand - pathology; Hand - surgery; hand tumour; Humans; Lung Neoplasms - secondary; Male; Medical sciences; metastasis; Pneumology; radical resection; Sweat Gland Neoplasms - diagnosis; Sweat Gland Neoplasms - pathology; Sweat Gland Neoplasms - secondary; Sweat Gland Neoplasms - surgery; Tumors of the respiratory system and mediastinum; Tumors of the skin and soft tissue. Premalignant lesions; acrospiroma; metastasis; hand tumour; radical resection; Human; Lung disease; Skin disease; Respiratory disease; Lung; Characteristic; Male; Surgical resection; Malignant tumor; Clear cell hidradenoma; Metastasis; Hand; Radical; Case study; Pathology; Histopathology; Treatment; Etiology; Surgery; Adult; Diagnosis; Bibliographic review; Sweat gland disease
• ISSN: 0748-7983; 1532-2157
• DOI: 10.1053/ejso.2000.1067

We present the case of a 37-year-old man with multiple pulmonary metastases of a primarily unknown primary tumour. Thorough revision of the medical history yielded that he had already passed three resections of a right palmar mass, which had been described as a benign tumour. Clinical examination showed a thickened scar with a suspicious palpable mass in the right hand. Excision of this scar and the tumour mass with histopathological examination now revealed a malignant acrospiroma. Resection of the pulmonary metastases histologically also confirmed a malignant acrospiroma. The following radical resection of the metacarpals II and III with the index and middle finger under the assumption of a wide compartment resection achieved tumour free margins and proved to be efficient with the patient being relapse free for 4 years from this operation. Although the prognosis of this tumour is generally unfavourable this particular case demonstrates the value of a radical surgical resection as the mainstay of treating such highly malignant sweat gland tumours of the hand.