Chondroid syringoma with osteoma cutis

Abstract

A 26-year-old man presented with an asymptomatic, slow-growing nodule on upper portion of the left cutaneous lip that had been present for approximately 2 years. He denied any bleeding, ulceration, or prior trauma to that area. Physical examination demonstrated a smooth-surfaced, firm, pedunculated nodule measuring approximately 1.1 cm in diameter (Fig 1). Nonpolarized dermatoscopy revealed a light pink nodule with white pleomorphic globules and irregularly enlarged branching telangiectasias conferring a marbled appearance (Fig 2). Histology demonstrated a well-circumscribed lobulated dermal nodule composed of epithelial structures in a myxomatous and chondroid stroma with irregular branching tubules and ducts. Calcium was present as well as focal areas of ossification (Fig 3, A-C).Key messageChondroid syringomas represent a relatively rare, mixed tumor of the skin that is thought to be of apocrine or eccrine origin. They commonly present as an asymptomatic, slow-growing nodule on the head and neck of older men.1Palit A. Sethy M. Nayak A.K. Ayyanar P. Behera B. Dermoscopic features in a case of chondroid syringoma.Indian J Dermatol Venereol Leprol. 2021; 87: 89-92https://doi.org/10.4103/ijdvl.IJDVL_167_20Crossref PubMed Scopus (2) Google Scholar Histologically, they present with varying ductal epithelial structures distributed within a chondromyxoid and fibrous stroma.1Palit A. Sethy M. Nayak A.K. Ayyanar P. Behera B. Dermoscopic features in a case of chondroid syringoma.Indian J Dermatol Venereol Leprol. 2021; 87: 89-92https://doi.org/10.4103/ijdvl.IJDVL_167_20Crossref PubMed Scopus (2) Google Scholar The presence of ossification in chondroid syringoma is exceedingly rare.2Bedir R. Yurdakul C. Sehitoglu I. Gucer H. Tunc S. Chondroid syringoma with extensive bone formation: a case report and review of the literature.J Clin Diagn Res. 2014; 8: FD15-FD17https://doi.org/10.7860/JCDR/2014/10026.5003Crossref PubMed Scopus (2) Google Scholar Dermatoscopy can provide an adjunctive measure for diagnosis of this adnexal neoplasm. The most predominant dermatoscopic feature for distinguishing dystrophic calcification and ossification in this tumor is the presence of white pleomorphic dots and globules, which, combined with the arborizing-like vessels, impart a marbled appearance. This is a novel dermatoscopic feature not previously reported.1Palit A. Sethy M. Nayak A.K. Ayyanar P. Behera B. Dermoscopic features in a case of chondroid syringoma.Indian J Dermatol Venereol Leprol. 2021; 87: 89-92https://doi.org/10.4103/ijdvl.IJDVL_167_20Crossref PubMed Scopus (2) Google Scholar Definitive treatment is by wide local excision with clear margins for prevention of recurrence.2Bedir R. Yurdakul C. Sehitoglu I. Gucer H. Tunc S. Chondroid syringoma with extensive bone formation: a case report and review of the literature.J Clin Diagn Res. 2014; 8: FD15-FD17https://doi.org/10.7860/JCDR/2014/10026.5003Crossref PubMed Scopus (2) Google Scholar Chondroid syringomas represent a relatively rare, mixed tumor of the skin that is thought to be of apocrine or eccrine origin. They commonly present as an asymptomatic, slow-growing nodule on the head and neck of older men.1Palit A. Sethy M. Nayak A.K. Ayyanar P. Behera B. Dermoscopic features in a case of chondroid syringoma.Indian J Dermatol Venereol Leprol. 2021; 87: 89-92https://doi.org/10.4103/ijdvl.IJDVL_167_20Crossref PubMed Scopus (2) Google Scholar Histologically, they present with varying ductal epithelial structures distributed within a chondromyxoid and fibrous stroma.1Palit A. Sethy M. Nayak A.K. Ayyanar P. Behera B. Dermoscopic features in a case of chondroid syringoma.Indian J Dermatol Venereol Leprol. 2021; 87: 89-92https://doi.org/10.4103/ijdvl.IJDVL_167_20Crossref PubMed Scopus (2) Google Scholar The presence of ossification in chondroid syringoma is exceedingly rare.2Bedir R. Yurdakul C. Sehitoglu I. Gucer H. Tunc S. Chondroid syringoma with extensive bone formation: a case report and review of the literature.J Clin Diagn Res. 2014; 8: FD15-FD17https://doi.org/10.7860/JCDR/2014/10026.5003Crossref PubMed Scopus (2) Google Scholar Dermatoscopy can provide an adjunctive measure for diagnosis of this adnexal neoplasm. The most predominant dermatoscopic feature for distinguishing dystrophic calcification and ossification in this tumor is the presence of white pleomorphic dots and globules, which, combined with the arborizing-like vessels, impart a marbled appearance. This is a novel dermatoscopic feature not previously reported.1Palit A. Sethy M. Nayak A.K. Ayyanar P. Behera B. Dermoscopic features in a case of chondroid syringoma.Indian J Dermatol Venereol Leprol. 2021; 87: 89-92https://doi.org/10.4103/ijdvl.IJDVL_167_20Crossref PubMed Scopus (2) Google Scholar Definitive treatment is by wide local excision with clear margins for prevention of recurrence.2Bedir R. Yurdakul C. Sehitoglu I. Gucer H. Tunc S. Chondroid syringoma with extensive bone formation: a case report and review of the literature.J Clin Diagn Res. 2014; 8: FD15-FD17https://doi.org/10.7860/JCDR/2014/10026.5003Crossref PubMed Scopus (2) Google Scholar None disclosed.