Keywords
Abstract
Background:
Porocarcinoma is a rare and aggressive malignant adnexal tumor arising from eccrine sweat glands, accounting for only 0.005% of skin tumors. Its occurrence in the upper lip is exceedingly uncommon, posing diagnostic and therapeutic challenges due to its rarity and aggressive potential.
Case Presentation:
We report a case of a 50-year-old female who presented with a 3×2 cm tender swelling over the left upper lip. Biopsy suggested a malignant adnexal tumor. The patient underwent wide local excision with left modified radical neck dissection. Histopathological examination revealed invasive tumor cells arranged in sheets and lobules, composed of poroid cells with moderate pleomorphism, high nuclear-cytoplasmic ratio, eosinophilic cytoplasm, atypical mitosis, cystic ductal structures, and stromal hyalinization, consistent with porocarcinoma. No lymph node metastasis was identified, and the tumor was staged as pT1N0. Postoperative contrast-enhanced imaging showed no residual disease or distant metastasis. The patient subsequently received adjuvant radiotherapy to a dose of 60 Gy in 30 fractions over six weeks.
Results:
Complete surgical excision with negative margins followed by adjuvant radiotherapy achieved favorable locoregional control. The absence of nodal involvement and metastatic disease suggested a good prognosis.
Conclusion:
Upper lip porocarcinoma is an exceptionally rare entity requiring a high index of suspicion for diagnosis. Histopathology remains the cornerstone for diagnosis, while aggressive multimodality treatment with surgery and adjuvant radiotherapy can lead to favorable outcomes. This case emphasizes the importance of multidisciplinary management in rare cutaneous malignancies.