F-18 FDG PET/CT Imaging of Eccrine Sweat Gland Carcinoma of the Scrotum with Extensive Regional and Distant Metastases

Document Type : Case report


Department of Nuclear Medicine, Konyang University Hospital, Daejeon, Republic of Korea


Eccrine carcinoma is an extremely rare malignant skin cancer arising from eccrine sweat glands with a high metastatic potential. It mainly occurs in the elderly, with equal incidence in both sexes. It usually spreads to regional lymph nodes, with liver, lungs, and bones being the most common sites of distant metastasis. Because of tumor rarity, little is known about the value of F18- FDG PET/CT in evaluating this disease. Our case report aims to increase current knowledge of F18- FDG PET/CT in eccrine sweat gland carcinoma as a noninvasive imaging tool for assessing the extension of the disease and detecting distant metastases. We reported a -96year-old man who presented with as lowly progressive, ill-margined erythematous papules and nodules with a crusted and eroded involving multiple sites of groin, scrotum, penis, left pelvic wall, left hip and left thigh for >3 years, which became extensive in the past 2 months. The histologic investigation confirmed the diagnosis of an eccrine carcinoma. He was performed F18- FDG PET/CT to further evaluate the lesions. FDG PET/ CT imaging revealed FDG uptake at the extensive skin lesion, involvement of lymph nodes, and multiple FDG-avid of liver, skeletal and lung metastases.


Main Subjects

  1. Osaki T, Kodate M, Nakanishi R, Mitsudomi T, Shirakusa T. Surgical resection for pulmonary metastases of sweat gland carcinoma. Thorax. 1994;49(2):181-2.
  2. Smith CC. Metastasizing carcinoma of the sweat-glands. Br J Surg. 1955;43(177):80-4.
  3. Murphy GF, Elder DE. Atlas of tumor pathology third series: non-melanocytic tumors of the skin. Washington, DC: Armed Forces Institute of Pathology; 1991.
  4. Requena L, Kiryu H, Ackerman AB. Neoplasms with apocrine differentiation. Philadelphia, Pa: Lippincott-Raven; 1998.
  5. Doley B, Das AK, Das M. Metastatic sweat gland carcinoma. J Assoc Physicians India. 2001;49:479-80.
  6. Mitts DL, Smith MT, Russell L, Bannayan GA, Cruz AB Jr. Sweat gland carcinoma: a clinico-pathological reappraisal. J Surg Oncol. 1976;8(1):23-9.
  7. Yildirim S, Aköz T, Akan M, Ege GA. De novo malignant eccrine spiradenoma with an interesting and unusual location. Dermatol Surg. 2001;27(4):417-20.
  8. Urso C, Bondi R, Paglierani M, Salvadori A, Anichini C, Giannini A. Carcinomas of sweat glands: report of 60 cases. Arch Pathol Lab Med. 2001;125(4):498-505.
  9. Panoussopoulos D, Darom A, Lazaris AC, Misthos P, Papadimitriou K, Androulakis G. Sweat gland carcinoma with multiple local recurrences: a case report. Adv Clin Path. 1999;3(3):63-8.
  10. Snow S, Madjar DD, Hardy S, Bentz M, Lucarelli MJ, Bechard R, et al. Microcystic adnexal carcinoma: report of 13 cases and review of the literature. Dermatol Surg. 2001;27(4):401-8.
  11. Hashimoto K. Adnexal carcinoma of skin. In: Freidman RJ, Rigel DS, Kopf AW, editors. Cancer of Skin. Philadelphia: Saunders WB; 1991. P. 209–16.
  12. Wick MR, Coffin CM. Sweat gland and pilar carcinoma. In: Wick MR, editor. Path physiology of unusual malignant cutaneous tumors. New York: Marcel Dekker; 1985. P. 1–76.
  13. Morabito A, Bevilacqua P, Vitale S, Fanelli M, Gattuso D, Gasparini G. Clinical management of a case of recurrent apocrine gland carcinoma of the scalp: efficacy of a chemotherapy schedule with methotrexate and bleomycin. Tumori. 2000;86(6):472-4.
  14. Blumer SL, Scalcione LR, Ring BN, Johnson R, Motroni B, Katz DS, et al. Cutaneous and subcutaneous imaging on FDG-PET: benign and malignant findings. Clin Nucl Med. 2009;34(10) :675-83.
  15. Juan YH, Saboo SS, Tirumani SH, Khandelwal A, Shinagare AB, Ramaiya N, et al. Malignant skin and subcutaneous neoplasms in adults: multimodality imaging with CT, MRI, and 18F-FDG PET/CT. AJR Am J Roentgenol. 2014;202(5):W422-38.
  16. Kumar R, Xiu Y, Zhuang HM, Alavi A. 18F-fluorodeoxyglucose-positron emission to-mography in evaluation of primary cutaneous lymphoma. Br J Dermatol. 2006;155(2):357-63.
  17. Li Y, Berenji GR. Cutaneous sarcoidosis evaluated by FDG PET. Clin Nucl Med. 2011;36(7):584-6.
  18. Joyce JM, Carlos T. Herpes Zoster mimicking recurrence of lymphoma on PET/CT. Clin Nucl Med. 2006;31(2):104-5.
  19. Egan C, Silverman E. Increased FDG uptake along dermatome on PET in a patient with herpes zoster. Clin Nucl Med. 2013;38(9):744-5.