Intracranial and spinal metastases from eccrine mucinous carcinoma: Case report Journal Article


Authors: Sheth, R. N.; Placantonakis, D. G.; Gutin, P. H.
Article Title: Intracranial and spinal metastases from eccrine mucinous carcinoma: Case report
Abstract: Background and importance: Mucinous eccrine carcinoma (MEC) is a rare but distinct type of sweat gland tumor. MECs tend to recur locally, and their spread to distant organs is very uncommon. This article describes the first case of MEC metastasizing to the brain and the spine. Clinical presentation: A 45-year-old female presented with a 2-year history of a scalp mass in the occipital area with lymph node spread. She underwent excision of the mass and neck lymph node dissection. Pathology confirmed the diagnosis of MEC. Postoperatively, she received radiation to the involved areas. Four years later the patient presented with left hemiparesis and underwent craniotomy for gross total resection of the metastasis. This recurred after 2.5 years and she underwent another craniotomy for gross total resection followed by whole brain radiation. In addition, the patient had metastases to T11 vertebral body and the left C6 to 7 neural foramen. Moreover, the patient developed leptomeningeal disease in the spine. The metastases to the spine were treated with radiation therapy. The patient died 1.5 years later. Conclusion: Even though it is rare for MEC to spread to distant organs, physicians should be aware of the risk of metastatic invasion of the brain and spine and be vigilant about surveillance of these sites. MEC metastases to the brain should be treated aggressively with surgical resection followed by stereotactic radiosurgery to the tumor bed. Spine metastases should be treated with a combination of surgery and image-guided radiation therapy, depending on the degree of cord compression from epidural metastatic disease. © 2010 by the Congress of Neurological Surgeons.
Keywords: adult; human tissue; histopathology; case report; postoperative period; cancer radiotherapy; brain radiation; nuclear magnetic resonance imaging; recurrent cancer; lymph node metastasis; lymph node dissection; brain metastasis; craniotomy; hemiparesis; spinal cord metastasis; meningeal metastasis; mucinous carcinoma; sweat gland carcinoma; scalp tumor; spinal metastasis; vertebra body; sweat gland tumor; intracranial metastasis; leptomeningeal disease; mucinous eccrine carcinomas; cervical spinal cord
Journal Title: Neurosurgery
Volume: 67
Issue: 3
ISSN: 0148-396X
Publisher: Wolters Kluwer  
Date Published: 2010-09-01
Start Page: E861
End Page: E862
Language: English
DOI: 10.1227/01.neu.0000377860.59894.a3
PROVIDER: scopus
PUBMED: 20657314
DOI/URL:
Notes: --- - "Export Date: 20 April 2011" - "CODEN: NRSRD" - "Source: Scopus"
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  1. Philip H Gutin
    163 Gutin
  2. Rishi N Sheth
    1 Sheth