P.118 A rare case of eccrine carcinoma with perineural metastases - a rare cause of facial pain
Bibliographic record
Abstract
Background: Eccrine carcinoma is a rare skin tumor arising in eccrine sweat glands with a predilection for older adults. Over 30% of cases occur in the head and neck. Local and distal metastases are common. Prognosis is poor with regional recurrence in up to 19% of cases. Imaging is indicated in high-risk disease. Methods: We present a case report of eccrine carcinoma in the scalp with perineural metastasis to the left trigeminal nerve. Results: A seventy-nine-year-old male with a history of left temporal scalp pre-cancerous lesion treated with liquid nitrogen two years prior presented with left facial pain and paresthesia. The gadolinium-enhanced MRI head showed a tiny sub-centimetre spiculated subcutaneous lesion in the left temporal scalp and perineural enhancement along the left auricotemporal, V3 and trigeminal nerves. Subsequent excisional biopsy of the temporal lesion showed a poorly differentiated eccrine carcinoma without local perineural invasion. Conclusions: Undifferentiated facial pain is a frequent indication for head imaging, usually with low diagnostic utility. However, scrutiny for perineural enhancement is necessary to avoid missing a potentially deadly process. Eccrine carcinoma is a rare type of skin cancer. Small, painless, indolent primary lesions may be overlooked clinically. Radiologists can affect outcomes in these cases.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.001 | 0.007 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".