Cuticular Poroma: A Rare Poroma Variant Simulating a Malignant Neoplasm That Often Harbors YAP1::NUTM1 Fusions Similar to Their Conventional Counterparts

Am J Dermatopathol. 2023 Aug 1;45(8):544-548. doi: 10.1097/DAD.0000000000002465. Epub 2023 Jun 15.

Abstract

Cuticular poroma is a rare variant of poroma composed of exclusively or predominantly cuticular cells, namely of large cells with ample eosinophilic cytoplasm. We report 7 cases of this rare tumor identified among 426 neoplasms diagnosed as poroma or porocarcinoma. The patients were 4 males and 3 females, ranging in age from 18 to 88 years. All presented with a solitary asymptomatic nodule. The location included knee (2 cases), shoulder, thigh, shin, lower arm, and neck (each 1). All lesions were surgically removed. No evidence of disease was observed in 5 patients with available follow-up (range 12-124 months).Microscopically, all neoplasms were composed of variably sized, focally closed packed, or interconnecting nodules constituted mostly of cuticular cells. Small poroid cells were a focal feature in 5 tumors, whereas in the remaining 2 cases, poroid cells with conspicuous but still in minority. Five neoplasms were somewhat asymmetric, with irregular outlines. Ductal differentiation and intracytoplasmic vacuoles were seen in 6 tumors. Other features variably encountered were conspicuous intranuclear pseudoinclusions, cystic change, occasional multinucleated cells, increased mitoses, and stromal desmoplasia. Four of the 5 tumors analyzed with next-generation sequencing yielded YAP1::NUTM1 fusions. In addition, various mutations, mostly of unknown significance were identified in one neoplasm.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Eccrine Porocarcinoma* / genetics
  • Female
  • Humans
  • Male
  • Middle Aged
  • Poroma* / genetics
  • Poroma* / pathology
  • Sweat Gland Neoplasms* / genetics
  • Sweat Gland Neoplasms* / pathology
  • Transcription Factors / genetics
  • Young Adult

Substances

  • Transcription Factors