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May 1986

Enlarging Ulcerated Tumor on the Back

Author Affiliations

The Cleveland Clinic Foundation (Drs Kantor and Bergfeld) and the Metropolitan Hospital of Cleveland (Dr Pomeranz)

Arch Dermatol. 1986;122(5):585-586. doi:10.1001/archderm.1986.01660170115032

REPORT OF A CASE  A 25-year-old woman presented with a four-year history of a slowly enlarging tumor on her back. The tumor had rapidly increased in size and had become tender and ulcerated during the six months prior to evaluation.Physical examination revealed a 5.2 × 3.8-cm violaceous-brown nodule with focal ulceration on the inferior aspect of the right scapular region of the patient's back (Fig 1). Enlarged right axillary lymph nodes were palpated. A chest roentgenogram showed multiple radiopaque nodules in the lung parenchyma (Fig 2).Skin (Figs 3 and 4) and lymph node (Fig 5) biopsy specimens were obtained.What is your diagnosis?

DIAGNOSIS:  Eccrine sweat gland carcinoma (SGC)—metastatic.

DISCUSSION  Sweat gland carcinoma was first described in 1865 by Cornil, whereas metastatic disease from SGC was first reported by Hedinger in 1911. Since that time, numerous case reports and literature reviews have been published, with the