BACKGROUND Eccrine porocarcinoma is an extremely rare skin adnexal malignant neoplasia with highly invasive and metastatic potential. We report an additional case of eccrine porocarcinoma with intracranial metastases. This case is characterized by a complete record of the progress of eccrine porocarcinoma, its immunohistochemistry after three operations showed a progressive increase in the level of Ki-67 index. CASE PRESENTATION We herein report a case of a 37-year-old-male with eccrine carcinoma occurring on the left posterior occipital scalp which invaded the skull and dura, presenting with progressive headache. This patient has performed three surgeries in total. During the last hospitalization, he underwent an extended surgical resection, lymphadenectomy, myocutaneous flap transplantation and vascular anastomosis in our institution. After surgery, he was treating with radiotherapy at 200 Gray in 12 fractions. But one year after the operation, he developed chest tightness, imaging examination and biopsy puncture revealed pulmonary metastasis. CONCLUSION Intracranial metastasis of eccrine porocarcinoma is a late event with poor prognosis. This case emphases on that progressively increased level of Ki-67 index may predict more chance to occur the intracranial metastasis of scalp eccrine porocarcinoma, long-term follow-up and appropriately dense follow-up interval is necessary.

中文翻译：

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一例以Ki-67指数水平逐渐升高为特征的内分泌性腺癌：病例报告和文献复习。

背景技术内分泌性腺癌是一种极少见的皮肤附件恶性肿瘤，具有高度的侵袭和转移潜能。我们报告了另一例颅内转移的内分泌性腺癌。该病例的特征是完整记录了内分泌性腺癌的进展，经过三次手术后其免疫组织化学显示Ki-67指数水平逐渐升高。病例介绍我们在这里报告了一名37岁的男性，患有内分泌癌，发生在左枕后头皮，侵犯了颅骨和硬脑膜，并伴有进行性头痛。该患者总共进行了三个手术。在上次住院期间，他在我们机构接受了广泛的手术切除，淋巴结清扫，肌皮瓣移植和血管吻合术。手术后，他接受了200 Gray的放射治疗，分为12部分。但术后一年，他出现了胸闷，影像学检查和穿刺活检穿刺显示出肺转移。结论内分泌性肺癌的颅内转移是晚期事件，预后较差。该病例的重点在于Ki-67指数的逐渐升高水平可能预示发生头皮内分泌性腺癌的颅内转移的机会更多，长期随访和适当的密集随访间隔是必要的。