Chondroid synringoma cs, pleomorphic adenoma of skin, is a benign tumor found in the head and neck region. Hyaline cells are commonly seen in mixed tumours and myoepitheliomas of salivary glands and rarely in chondroid syringomas. The chondroid matrix has few cells, some of which resemble chondrocytes. Clear cell syringoma are commonly associated with diabetes mellitus. Because of the unremarkable clinical presentation of this rare tumour, the diagnosis is made on microscopic examination. In our patients, a middle aged woman, the tumor was on the scalp and recurred after previous excision. The tumour is composed of both epithelial and mesenchymal components. The incidence of cs among primary skin tumors is low and it is usually seen in middle aged or older male patients as a small, single dermal or subcutaneous nodule in the. The tumor cells were positive for high and lowmolecularweight keratin, epithelial membrane antigen, and vimentin. An 81yearold man underwent excisional biopsy of a big cylindric painless mass of the right lower eyelid, which had been present for over 23 years. Chondroid syringoma definition of chondroid syringoma by. This report describes a man with multiple scalp lesions exhibiting features of chondroid syringoma with small. Due to their rarity, they are often clinically misdiagnosed and with the diagnosis only con.
Pathology of chondroid syringoma mixed tumour of the skin. First described by hirsch and helwig in 1961, chondroid syringomas css are rare, benign tumors of the skin arising from the eccrine sweat glands with tumor differentiation in the epithelial and mesenchymal tissues. Results patients were typically asymptomatic, presenting with a slowly enlarging, nontender nodule of 2 to 8 years duration. Chondroid syringoma also known as mixed tumor of skin usually benign face, head, neck, extremities, trunk or back may have areas of apocrine, follicular and sebaceous differentiation gross.
Chondroid syringoma mix inflammatory infiltration scrotum. Chondroid syringomacutaneous mixed tumor low magnificationlow magnification shows a wellcircumscribed tumor composed of epithelial islands with easily identifiable glandularductal structures embedded in a myxoid and hyaline stroma. To further characterize pilosebaceous differentiation and to identify the presence of merkel cells in the areas of follicular differentiation. There is no evidence to prove that oily foods and chocolatebased products have an influence on chondroid syringoma formation cleaning the skin too hard with strong chemicals or soaps may aggravate the skin condition. Pdf nodular hidradenoma is a distinctive sweat gland neoplasm. It presents as a firm, dermal or subcutaneous nodule, usually between 0. The secondary structures include glands and ducts, cysts, reticular lacelike networks, keratinous cysts and foci of squamous differentiation. A biplastic tumor or biphasic tumor has two tissue types. Chondroid syringoma or mixed tumor of the skin is a rare epithelial tumor with eccrine differentiation. They most commonly occur in the head and neck, although they may be also found in the axilla, trunk, limbs, and genitalia. Final case analysis round f maidstone and tunbridge wells nhs.
Apocrine mixed tumours form a well circumscribed dermal mass. Chondroid syringoma is a rare, benign skin tumour arising from the sweat glands with an incidence of approximately 0. Three cases occurred in the hand and one in the foot. Fineneedle aspiration cytology of chondroid syringoma of. Chondroid syringoma, or cutaneous mixed tumor, is an adnexal neoplasm of either apocrine or eccrine origin. These benign lesions are of possible eccrine gland or hair follicle origin, although several reports showed apocrine differentiation. Syringoma is a benign adnexal tumour originating from the intraepidermal portion of the eccrine duct.
Chondroid syringoma cs of the orbit is virtually a rare benign neoplasm. Chondroid syringoma is also known as mixed tumour of the skin. Giant chondroid syringoma of the lower eyelid ncbi nih. It is also known as a cutaneous pleomorphic adenoma, benign mixed cutaneous tumour or eccrine mixed tumour as it contains both epithelial and mesenchymal elements. Chondroid syringoma, or pleomorphic adenoma of the skin, is a rare, benign skin adnexal tumor. Department of pathology, faculty of medicine, dumlupinar university kutahya, turkey. Chondroid syringoma, he 60x 6386 chondroid syringoma, alcian blue 60x 6385 chondroid syringoma, cea 40x 6383 chondroid syringoma, vimentin 40x 6384. Besides, the adnexa of the skin also give rise to appendage tumours like eccrine spiradenoma and chondroid syringoma. It is usually exhibited as a slowly growing intradermal or subcutaneous nodule, typically located in the head and neck region. The name syringoma is derived from the greek word syrinx, which means pipe or tube. Chondroid syringoma behave more aggressively than do other skin carcinomas. In contrast to the benign counterpart, which is common in the head and neck region, the malignant variety occurs predominantly on the trunk and extremities.
Four of the lesions were on the eyelid margin, three in the sub. Syringoma treatment, removal, pictures, causes, surgery. A chondroid syringoma is a rare mixed tumor of sweatgland origin that has both a benign and malignant form. These lesions present as nondescript dermal nodules which grow slowly. The cutaneous lesion has different behaviour in that it rarely recurs even if inadequately excised. According to wick mr et al in a series of 14 patients with this tumour who underwent surgical excision with negative margin,11 had at least one local recurrence and 5 had recurrence in regional nodes or distant sites. Origin from a preexisting benign chondroid syringoma was clearly evident in both neoplasms. About europe pmc funders joining europe pmc governance roadmap outreach. Apocrine mixed tumour is also known as apocrine chondroid syringoma. Chondroid syringoma, or mixed tumor of skin, is a relatively rare, usually benign sweat gland tumor, most often seen in the headandneck region. Cutaneous mixed tumor chondroid syringoma basicmedical key. Pdf malignant chondroid syringoma presenting as multiple. The term syringoma is derived from the word syrinx, meaning pipe or tube.
Syringocystadenoma papilliferum an overview sciencedirect topics. Other cells present include plasmacytoid, low cuboidal, spindled, clear cell, cells with follicular and pilomatrical differentiation and mature adipocytes. The chondroid syringoma is an extremely rare skin tumor most commonly found in the area of the head and neck region. Apr 24, 2017 chondroid syringoma cutaneous mixed tumor low magnificationlow magnification shows a wellcircumscribed tumor composed of epithelial islands with easily identifiable glandularductal structures embedded in a myxoid and hyaline stroma. An 84yearold man presented with an enlarging bluish, painless subcutaneous nodule on the glabella.
This case is being reported for its rarity this is the 28 th case in literature involving ocular adnexa, its occurrence in a young patient and the need to keep this rare. It may arise from eccrine or apocrine glands, it occurs most commonly in the head and neck regions and may involve the face and eyelids, where it has been described 16 as a small nodule in the upper lid. Cutaneous benign mixed tumor chondroid syringoma of the. These lesions are common in patients with down syndrome. Cutaneous benign mixed tumor chondroid syringoma of the ey. Dermal chondroid syringoma yamini krishna natalie meara abstract chondroid syringoma or mixed skin tumour is a rare, benign skin adnexal tumour which typically occurs in the head and neck region of middleaged patients. Papanikolaou, essaloniki, greece department of pathology, general hospital of g. A mixed tumor is a tumor that derives from multiple tissue types. Cutaneous benign mixed tumor chondroid syringoma of the eyelid. Chondroid syringoma cs is a rarely seen benign tumor rooted in the epithelial and mesenchymal cells of the skin. Hirsch and helwig named it chondroid syringoma because of the presence of sweat gland elements in a cartilaginous stroma and the histological criteria for diagnosis. The purpose of this letter is to describe in more detail the clinical appearance of an example of this unusual tumor.
These distinctive tumours are composed of both a mesenchymal component which is. Chondroid syringoma may be confused clinically with epidermal cyst, pilar cyst, calcifying. Case report facial localization of malignant chondroid. Low power showed multiple wellcircumscribed cystic spaces lined by tissue having biphasic growth pattern figure 3 with epithelial elements in the form of nonbranching bilayered tubules as well as solid nests embedded within a predominantly fibrous and focally. A small wellcircumscribed subcutaneous lesion adherent to the skin. Epithelial components derived from folliculosebaceousapocrine germ are evident in apocrine but not in eccrine cs. They are typically found on the eyelids, but may also develop in other parts of the body with sebaceous ducts such as. Histopathologic and immunohistochemical examination showed a chondroid syringoma, an uncommon benign neoplasm of possible eccrine sweat gland origin, which occurs generally in the head and neck skin. Chondroid syringoma how is chondroid syringoma abbreviated. Chondroid syringoma is a rare mixed tumor accounting for only 0. Chondroid syringoma is a benign tumor but incomplete excision can undergo malignant transformation. Chondroid syringoma cs is a benign cutaneous adnexal tumor with epithelial and stromal components.
Malignant adnexal neoplasms modern pathology nature. Mar 31, 2014 chondroid syringomas may have all five characteristics or manifest only some. Apr 01, 2009 benign chondroid syringoma mixed tumor discussion a chondroid syringoma is a rare mixed tumor of sweatgland origin that has both a benign and malignant form. Report of two cases in young patients lakhan singh solanki md 1, mandeep dhingra 1, mala bhalla md 1, gurvinder pal thami md 1, rps punia md 2, shilpy batra md 2 dermatology online journal 17 12. Syringomatous adenomas of nipple aka syringoma of the nipple.
As far as the latest information is concerned with updated knowledge and visualizing techniques this is the rare case. Chondroid definition of chondroid by the free dictionary. Chondroid syringoma of the scrotum with mix inflammatory. Chondroid syringomas may have all five characteristics or manifest only some. A true mixed tumor contains multiple types of neoplastic cells. An introduction to dermatopathy is found in the dermatopathology article. Webpathology is a free educational resource with 10308 high quality pathology images of benign and malignant neoplasms and related entities. Collectively, dermatologic cancers are the most common form of cancer. Two cases of chondroid syringoma of the hand sciencedirect. Some sources require the included tissue types to be neoplastic for the definition of mixed tumor a false mixed tumor contains one type of neoplastic cells, but which have more than one appearance. Case reports in oncological medicine of malignancy.
We are report 2 unique cases of mcs, one occurring on the scalp of a. Case report chondroid syringoma of the medial canthus konstantinosparaskevopoulos, 1 angelikicheva, 2 giorgoskoloutsos, 1 ioannismatzarakis, 2 andkostasvahtsevanos 1 department of oral and maxillofacial surgery, general hospital of g. Though its very common occurrence is in head and the neck region, involvement of eyelids is. Histopathology revealed a chondroid syringoma with extensive cystic changes. The variant with small tubular lumina is extremely uncommon. Clinically cs presents typically as a slow growing painless firm. Article benign chondroid syringoma applied radiology. Proliferation of benign ducts with lined by a bilayer as in normal sweat ducts with abnormal architecture. Chondroid syringoma is a different benign adnexal tumor with a characteristic myxoid cartilaginous matrix and is analogous to the benign mixed tumor pleomorphic adenoma of salivary gland.
Cytological features of chondroid syringoma have been published very rarely in the literature. Chondroid tissue definition of chondroid tissue by medical. Mar 27, 2019 syringoma is a benign adnexal neoplasm formed by welldifferentiated ductal elements. Because of the unremarkable clinical symptomatology of this rare tumor, the diagnosis is exclusively made retrospectively based on histological confirmation of the surgically. Chondroid syringoma or cutaneous mixed tumors are rare benign skin adnexal tumors accounting for only about 1% of commonly encountered skin tumors. Chondroid syringoma, apocrine, he 20x 1993 mixed tumor of the skin. Hirsch and helwig named it chondroid syringoma because of the presence of sweat gland elements in a cartilaginous stroma 1 and the histological criteria for diagnosis. Four cases of chondroid syringoma containing large numbers of hyaline or plasmacytoid cells are described. The lesion is of low signal intensity on t1, heterogeneous but predominantly low on t2, and demonstrates avid enhancement on post gad sequences. Chondroid syringoma is a benign mixed tumor characterized by sweat gland elements in a cartilaginous stroma. Additional and relevant useful information for chondroid syringoma. The lesions ranged from 4 mm to 17 mm in greatest dimension. It is generally localized in the head and neck region and rarely in the extremities.
Chondroid tissue definition of chondroid tissue by. Chondroid syringoma is a rare benign skin adnexal tumor, the cytological features of which have been published very rarely in the literature. It includes dermatologic cancer, which can be deadly. Chondroid syringoma represents the cutaneous counterpart of mixed tumor pleomorphic adenoma of salivary glands, therefore it is also termed mixed tumour of the skin. Chondroid syringoma with small tubular lumina springerlink. Nonmalignant disease is covered in the nonmalignant skin disease article. Chondroid syringoma cs, an uncommon skin appendageal tumor, is also referred to as cutaneous mixed tumor because it consists of both epithelial and myoepithelial cell types. The hyalinecell change in three of the cases initially.
Eruptive this form typically presents on the anterior chest, abdomen, neck and arms. While usually solitary, cases with multiple lesions have been reported. It is now widely accepted that fine needle aspiration cytology fnac is useful in diagnosis of skin adnexal tumors. Nasse, first described a case of skin tumor containing both epithelial and mesenchymal components in 1892. This is the first report of multiple chondroid syringoma with small tubular lumina. Giant chondroid syringoma radiologically mimicking malignancy. This article deals with dermatologic neoplasms, also known as skin tumours.
Facial localization of malignant chondroid syringoma. It presents in successive crops with periods of relief in between times of active rash milialike this type of syringoma is typically smaller lesions that have a milky white center that can look like milia plaque type this type is more commonly associated with itchiness and chronic scratching that. Case report chondroid syringoma of the medial canthus. Department of pathology government medical college and hospital, chandigarh, india abstract. Introduction chondroid syringoma is also known as pleomorphic adenoma or mixed tumor of the skin.
The epidermis typically exhibits a reactive papillary hyperplasia and merges with. Chondroid syringoma is usually present as a single subcutaneous nodule. Chondroid syringoma is a tumor arising from the sweat glands which can be apocrine found throughout the surface of lid or eccrine glands of moll in association with eyelash follicles with a mean age of 50 years 2273 years. Microscopic findings revealed multiple chondroid syringoma with small tubular lumina. Syringoma is a tumor in the sweat ducts that are commonly harmless. Benign chondroid syringoma mixed tumor discussion a chondroid syringoma is a rare mixed tumor of sweatgland origin that has both a benign and malignant form. Recurrent chondroid syringoma of the alar rim europe pmc. They most often arise on the skin of the head and neck. Chondroid syringoma cs mixed tumor of the skin is a rare neoplasm of the sweat glands, which presents itself as a slowgrowing, painless, nonulcerated. Chondroid syringoma chondroid syringoma is a rare benign skin adnexal tumor of eccrineapocrine origin affecting commonly the head and neck region. Cutaneous mixed tumor with ductal lumina and myxoid stromasmall ducts lined by cuboidal cells are a common finding. A mucoid aspirate, abundant chondromyxoid matrix material, and epithelial components were suggested as diagnostic criteria. Some forms show a fibromyxoid stroma, which has caused some authorities to label such lesions malignant chondroid syringoma, while others.
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