Abstract Background Eccrine porocarcinoma ( EPC ) is a rare malignant tumor of the eccrine sweat gland. It is a potentially fatal neoplasm that is locally aggressive and commonly recurs. Wide surgical excision has traditionally been the treatment of choice and is curative in approximately 70–80% of cases. The disease is metastatic to lymph nodes and distant sites in 20% and 10% of cases, respectively. Metastatic EPC has not shown any great response to adjuvant chemotherapy or radiation. Objective The purpose of this study was to evaluate the efficacy of Mohs micrographic surgery ( MMS ) for EPC as an alternative to wide local excision. Methods Five patients diagnosed with EPS between 2011 and 2014 at the University of Louisville and treated with MMS were studied. Recurrence‐free periods subsequent to the treatment of EPC with MMS were measured. Results The five patients with EPC treated by MMS remained recurrence‐free for a mean of 11 months (range: 2–26 months). Conclusions Mohs micrographic surgery is a highly effective treatment for EPC . Given the high rate of recurrence, propensity for lymph node metastases, and the often ineffective options for treating advanced disease, MMS should be considered in the treatment of all cases of EPC .
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Generalized dystonia is a disabling disorder that can severely affect quality of life. Pharmacological treatment is unsatisfactory, and surgical therapy has been the focus for symptom improvement. We present the first case report of a patient with disabling generalized dystonia treated with a thalamotomy and deep brain stimulation of the thalamus and globus pallidus (DBS-Vim, DBS-GPi). His tremor and dystonic symptoms have dramatically improved through combining these surgical interventions.
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