Abstract

A 74-year-old female presented in January 1995 with indurated plaques and ulcerson her left thigh. These lesions had first appeared as nodules at the age of about 60 years and had slowly spread and ulcerated. The patient had never received anytreatment for the skin lesions because of her antipathy to doctors.
Physical examination revealed numerous indurated erythematous plaques withsuperficial ulcers and nodules on the left thigh and edematous swelling of the entireleft leg. Several indurated erythematous plaques and nodules were also seen on theleft lower leg, perineum and right inguinal resion. A chest X-ray showed pulmonarymetastatic lesions and atelectasis of the left lung field. CT scan disclosed swelling ofthe celiac lymph nodes but no tumor originated from internal organs. Serum CA-125 level was elevated in all the course of the disease. We supposed that the neoplasm onthe patient's left thigh originated from the skin. She died of multiple organ failure in March 1995.
Histologically, the many tumor cell nests were seen. in the dermis. Some of themshowed restiform-like pattern. Vacuoles were also seen in the tumor cell. Electronmicroscopical examination revealed tonofilaments in tumor cells, cell membraneswith complex interdigitating microvilli-like processes, desmosomes and intracellulartubules. These findings suggest that the neoplastic cells differenciated to eccrinesweat gland, and especially resemble eccrine porocarcinoma.