Benign Skin Adnexal Tumor Research Articles

Benign vs. Malignant skin adnexal neoplasms: How useful are silhouettes?

Background:Skin adnexal tumors are daunting diagnostic problems. Cytologic atypia does not always imply malignancy and “typia” does not underscore a benign course. Bernard Ackerman first described criteria on silhouettes that enable distinction between the two.Aims:To evaluate the histologic features on silhouettes of benign and malignant skin adnexal tumors. To identify overlaps and confounding features.Materials and Methods:A blinded retrospective review of all skin adnexal neoplasms between 1995 and 2007 was done, with a total of 68 cases. We studied 16 histologic parameters on scanner view and categorized them as benign or malignant. They were compared with the final histologic diagnosis. Statistical analysis was performed using chi-square test.Results:15 criteria attained statistical significance. Features that proved highly sensitive and specific were: Circumscription, ulceration, uniform size of cell aggregates, discrete arrangement, preserved adnexae and necrosis. Criteria that were sensitive but not very specific include: Symmetry, V-shape, vertical orientation, smooth margins, compressed fibrous tissue, type of clefting, shelling out and geometric shapes. Presence of epithelial cells in singles was not helpful.Conclusion:Malignant skin adnexal tumors are differentiated accurately from benign ones by their contrasting silhouettes. Pathologists should heed the impression formed on scanner view, before evaluating cytologic features.

Giant chondroid syringoma with divergent differentiation: Cyto-histo-immuno correlation

Chondroid syringoma is a rare benign skin adnexal tumor of eccrine/apocrine origin affecting commonly the head and neck region. It is also called as mixed tumor of skin because of the presence of both the epithelial and mesenchymal components. There are very few case reports of chondroid syringoma diagnosed on fine needle aspiration cytology (FNAC). We hereby report a case of giant chondroid syringoma occurring over the lower back in a 50-year-old male, diagnosed initially on cytology and confirmed by histopathology. This case is reported for its unusual size and site of occurrence. We describe the clinical features, cytology, histopathology, immunohistochemistry, and differential diagnosis of giant chondroid syringoma along with review of literature.

Chondroid syringoma: A case with unusual cytological findings

Chondroid syringoma is a rare benign skin adnexal tumor, the cytological features of which have been published very rarely in the literature. A mucoid aspirate, abundant chondromyxoid matrix material, and epithelial components were suggested as diagnostic criteria. The reported case is one of chondroid syringoma confirmed by histopathology, the fine needle aspiration cytology of which yielded thin fluid-like material and microscopy revealed epithelial clusters with admixed smaller myoepithelial cells, background cyst macrophages, and only scanty chondromyxoid stromal elements. Including these cytological features of the present case among the diagnostic criteria for cytodiagnosis of chondroid syringomas might increase the chances of a definitive preoperative diagnosis and help in planning the extent of surgery.

Mixed Tumour of Ala-Nasi: A Rare Case Report and Review

A chondroid syringoma or a mixed tumour of skin, is a rare, benign skin adnexal tumour of sweat gland origin, which is most commonly seen in the head and neck region of patients who are in the sixth and seventh decades. These tumours usually present as asymptomatic, slowly growing masses. We are reporting a rare case of a chondroid syringoma of Rt. ala nasi in a 50 years old female. The swelling had started 4 years back as a small nodule and it had gradually increased in size to 2x2 cms. It was located subcutaneously and it was projecting into the anterior nares. A clinical diagnosis of a benign adnexal tumour (adenoma) or a solitary neurofibroma was made and an excision was planned. Histopathology revealed features of a chondroid adenoma. We are reporting this case because of its rare and unusual site of occurrence and so far, in the available literature, no such case has been reported on tumours of alanasi.

Dorsal Nasal Mucocele: A Delayed Complication of Rhinoplasty

Objective: To describe an interesting case of a subcutaneous dorsal nasal mucocele that developed 21 years after primary endonasal rhinoplasty and to list methods by which this delayed complication can be avoided. Method: A 51-year-old man presented with a 2-year history of a slowly growing asymptomatic mass on the nose which was lateral to midline, cephalic to the lower lateral cartilages, and superficial to the upper lateral cartilage while remaining deep to the subcutaneous tissues. Results: Fine needle aspiration was performed and was nondiagnostic, as only epithelial cells were identified. Imaging studies indicated a 1-cm low-density, difficult-to-characterize nodule on the inner aspect of the right nostril. The patient was taken to surgery, and an open rhinoplasty approach was used to access the mass. It was a well-demarcated, globular, fluid-containing cystic structure that did not track to the skin or vestibular surface. The differential diagnosis for nasal lesions in this area include inclusion cysts, benign skin adnexal tumors, dermoid cysts, encephaloceles, and minor salivary gland neoplasms. Pathology demonstrated findings consistent with mucocele. Conclusion: It is likely that the patient had mucosal tissue from the nasal vault trapped subcutaneously during rhinoplasty. Over years, this grew to become cosmetically symptomatic. Prevention of this rare long-term complication of rhinoplasty requires well-defined incisions and meticulous attention to wound closure. Treatment herein was via an open rhinoplasty approach.

Nodular hidradenoma of male breast: Cytohistological correlation

Nodular hidradenoma is an established entity as a skin adnexal tumor arising from eccrine sweat glands. A skin adnexal tumor located in the breast is unusual and is one of the differential diagnoses for subareolar breast nodules. With the exception of gynecomastia, other lesions of the male breast are not very common. The review of literature showed only 25 reported cases till date. The rarity of this neoplasm and failure to identify its morphologic features may lead to misdiagnosis. Being itself rare, cytological features of this lesion are hardly encountered in case reports. We report a case of an 18-year-old male who presented with a left breast lump and underwent fine needle aspiration and was diagnosed as having a benign skin adnexal tumor. Later it was confirmed by histopathology to be a nodular hidradenoma.

Trichoblastoma of the Breast Detected by Screening Mammography: A Diagnostic Pitfall

Trichoblastoma of the Breast Detected by Screening Mammography: A Diagnostic Pitfall

Chondroid syringoma diagnosed by fine needle aspiration cytology

Chondroid syringoma is a rare benign skin adnexal tumor of eccrine/apocrine origin affecting commonly the head and neck region. It used to be previously called as mixed tumor of skin because of the presence of both the epithelial and mesenchymal components. There are only few case reports describing the fine needle aspiration cytologic features of chondroid syringoma for diagnosis. We studied a 20-year-old male case from Taplejung district of Nepal came to Otorhinolaryngology out patient department with the complaints of painless, progressively enlarging swelling on the dorsum of nose. On examination, 2.0 x 2.0 cm, firm, non-tender swelling was seen on the right side of dorsum of nose. Overlying skin was normal, and the swelling was fixed to the skin but freely mobile over underlying structure. A clinical diagnosis of dermoid cyst was entertained, and the case was subjected to FNAC. FNA yielded mucoid material which on microscopy showed clusters of round cells with moderate to abundant cytoplasm embedded in chondromyxoid ground substance. The nuclei were monomorphic, centrally to eccentrically located and had fine chromatin. On the basis of these cytologic features, a diagnosis of chondroid syringoma was made. We concluded that Chondroid syringoma may be considered as a rare differential diagnosis in the swelling of head and neck region and the diagnosis can be easily confirmed or ruled out by means of fine needle aspiration cytology.

Podoplanin is a Highly Sensitive and Specific Marker to Distinguish Primary Skin Adnexal Carcinomas From Adenocarcinomas Metastatic to Skin

Distinction of primary skin adnexal carcinomas from cutaneous metastasis of adenocarcinomas is challenging. In this study, we evaluated podoplanin immunoreactivity in a series of primary skin adnexal tumors and adenocarcinomas metastatic to skin using a D2-40 antibody. The initial test series were composed of a total of 93 cases including 32 primary skin adnexal carcinomas, 46 benign primary adnexal tumors, and 15 cutaneous metastatic adenocarcinomas. We found that variable D2-40 reactivity was seen in all of the primary cutaneous carcinomas including sebaceous carcinomas (10/10), squamous cell carcinomas (10/10), porocarcinomas (4/4), trichilemmal carcinomas (4/4), skin adnexal carcinomas not otherwise specified (4/4), and in the majority of benign skin adnexal tumors. In contrast, no podoplanin immunoreactivity was seen in any of the 15 (0/15) cutaneous metastases. To confirm the initial findings and to further explore the utility of podoplanin reactivity in the distinction of these tumors, we also examined a test set of 35 unknown cases, including 21 adenocarcinomas metastatic to skin and 14 primary adnexal tumors, in a blinded fashion. In this test set of cases, podoplanin was negative in 22 cases and positive in 13 cases. Of the 22 podoplanin negative cases, 20 were proven to be metastatic adenocarcinoma. Of the 13 D2-40 positive cases, 12 were proven to be primary adnexal tumors. Our results suggest that podoplanin can be a useful tool to distinguish primary skin adnexal carcinomas form adenocarcinomas metastatic to skin with high sensitivity (94.5%) and specificity (97.2%).

The chondroid syringoma: report of a case arising from the external auditory canal

Chondroid syringoma is an uncommon, benign skin adnexal tumour. It usually presents as a slowly growing intradermal or subcutaneous nodule on the face. Treatment involves local excision with a cuff of normal tissue to prevent recurrence. A rare case of chondroid syringoma arising from the external auditory canal is reported. The clinical features, histology, treatment and follow-up are discussed.

Proliferating trichilemmal cyst of the eyebrow

This case report describes an unusual tumor called proliferating trichilemmal cyst, a benign skin adnexal tumor that is invasive in its behavior. It very rarely occurs in a young person’s face. Bone erosion is a very rare complication. Obliterating the frontal sinus requires a sufficient volume of vascular tissue. The composite galeofrontalis pericranial flap and oblique forehead flap were used in conjunction at the same site to obliterate the sinus and cover the skin and soft tissue defect.

Fine Needle Aspiration Cytology of Pilomatricoma: Case Report and Review of Literature

Pilomatricoma is a benign skin adnexal tumor that is underrecognized by fine needle aspirate, often times resulting in an overdiagnosis of malignancy. We present the fine needle aspirate of a 7-month-old child with a pilomatricoma of the cheek. The differential in this age group includes epidermal, dermoid, and branchial cleft cysts, thyroglossal duct remnants, granulomatous lymphadenitis, juvenile xanthogranuloma, and embryonal rhabdomyosarcoma. Recognition of the ghost cells and clinical correlation should allow accurate diagnosis of this entity.

Eyelid Microcystic Adnexal Carcinoma

Microcystic adnexal carcinoma is an uncommon cutaneous tumor with multiple synonyms. On cursory microscopic examination, the tumor mimics syringoma and other benign skin adnexal tumors. However, the asymmetric, infiltrative growth pattern clearly sets the lesion apart as carcinoma. The tumor is locally aggressive, with recurrences common, but regional metastases are rare. Histogenesis is controversial. Optimal treatment consists of complete surgical excision with clear surgical margins.