Tumors Of Salivary Gland Origin Research Articles

Role of intraoperative tumour spillage in prognostic outcome of pleomorphic adenoma: A systematic review

AbstractBackgroundPleomorphic adenoma (PA) is the most common neoplasm of salivary gland origin. The exact cause of PA recurrence is ambiguous. Incomplete surgical excision and violation or accidental rupture of tumour capsule are the widely accepted causes.AimTo study intraoperative tumour spillage‐associated recurrence and prognosis in cases of PA of the parotid gland.Materials and MethodsA systematic literature search was performed to include case series and observational studies discussing about intraoperative tumour spillage and recurrence in PA of the parotid gland. Quality assessment for the included studies cases was performed based on Joanna Briggs Institute checklist.ResultsA total of 27 studies were included in this review. The majority of the studies reported about cases of intraoperative tumour spillage in PA of the parotid gland. Overall, 12 studies specifically mentioned about the relation of tumour spillage with tumour recurrence. A total of 3 studies observed the association between the mode of treatment and tumour spillage and recurrence.ConclusionIntraoperative tumour spillage is a major factor responsible for PA recurrence. A comprehensive knowledge of the recurrence risk factors is of utmost importance. The results of this systematic review aim to make clinicians and surgeons aware that the capsular status of PA is a principal aspect to be taken care of.

Intraoral Sialadenoma Papilliferum: A Comprehensive Review of the Literature with Emphasis on Clinical and Histopathological Diagnostic Features

Background. Sialadenoma papilliferum (SP) is a rare benign epithelial tumor of salivary gland origin, its diagnosis being potentially challenging. It was first described by Abrams and Finck in 1969 as an analog of the cutaneous syringocystadenoma papilliferum. The aim of this comprehensive review is to highlight the clinical and histopathological diagnostic aspects of intraoral SP, analyzing cases previously described and reporting new cases. Methods. Medline, Scopus, and Web of Science were searched up to February 2022, using as entry term “sialadenoma papilliferum”. No time limits were applied and only studies in English were taken into account. Only cases involving the mouth were included. Conference proceedings, personal communications, and letters to the editor were excluded. Results. In total, 42 out of 234 articles fulfilled the inclusion criteria, with 64 cases reported. Mean age of patients with SP was 57.2 years, with a higher prevalence among males. The most affected site was the palate, particularly the hard palate. Four cases with uncertain malignant features have been reported. While clinical manifestations of SP are rather unspecific (e.g., submucosal swelling with ulceration), histopathological and immunohistochemical features are quite peculiar, SP have a limited growth potential, leading to conservative excision as treatment of choice. Conclusions. SP, though rare, should be taken into consideration in the differential diagnosis of intraoral swellings, particularly those located on the palate.

Surgical Management of Parapharyngeal Tumors: Our Experience.

Context Tumors of parapharyngeal space (PPS) are rare and histologically diverse. The management of these tumors requires diligent assessment and planning with due consideration of various anatomical and pathological aspects of the lesion. Aims This retrospective study aims to present our experiences in the clinical and pathological aspects of PPS tumors with a critical evaluation of management. Settings and Design Retrospective analytical study. Methods and Material The electronic medical records of 60 cases of PPS tumors, managed surgically from 2007 to 2017, were reviewed and analyzed using SPSS 22 software. The mean follow-up duration was 44 months. Results The mean age was 45 years with a male-to-female ratio of 1.7 (38:22). The majority of the tumors were benign (71.7%) and the most common presentation being upper neck mass or oropharyngeal mass. Histologically, neurogenic tumors were most common (43.3%) PPS tumors, followed by tumors of salivary gland origin. Magnetic resonance imaging was used as a diagnostic modality in 70% of cases, and computed tomography scan and positron emission tomography/CT were used in 26.7 and 3.3% of cases, respectively. In our study, the diagnostic accuracy of fine-needle aspiration cytology was 71% for benign and 47% for malignant lesions. The most common approach for surgery used was transcervical (72%). Conclusion The study reveals that cranial nerve palsy is the most common complication associated with PPS tumors. Completely resected, malignant tumors originating within PPS have a good prognosis, as compared with tumors extending or metastasized to PPS.

ADENOMATOID HYPERPLASIA OF THE PALATE: AN UNCOMMON LESION OFTEN MIMICKING SALIVARY GLAND TUMOR

Adenomatoid hyperplasia of the minor salivary glands is an uncommon benign proliferation of mucous glandular tissue. This lesion may clinically resemble a neoplasm of salivary gland origin. We present a case of an adenomatoid hyperplasia of minor salivary glands on the palate. A 42-year-old female patient was referred after presenting with a painless swelling of approximately 1.5 cm diameter in the left side of the hard palate. An excisional biopsy was performed. Microscopically, the specimen presented several lobules of minor salivary gland, all almost constituted by mucinous acini. At the periphery, hyperkeratotic stratified squamous epithelium lining, with mild chronic inflammation in the underlying connective tissue, was observed. The patient continues to be observed, and there has been no evidence of recurrence after 6 months’ of follow up. The adenomatoid hyperplasia pathogenesis remains unknown; however, clinicians should be aware of this condition, which may mimic a salivary gland neoplasm. Adenomatoid hyperplasia of the minor salivary glands is an uncommon benign proliferation of mucous glandular tissue. This lesion may clinically resemble a neoplasm of salivary gland origin. We present a case of an adenomatoid hyperplasia of minor salivary glands on the palate. A 42-year-old female patient was referred after presenting with a painless swelling of approximately 1.5 cm diameter in the left side of the hard palate. An excisional biopsy was performed. Microscopically, the specimen presented several lobules of minor salivary gland, all almost constituted by mucinous acini. At the periphery, hyperkeratotic stratified squamous epithelium lining, with mild chronic inflammation in the underlying connective tissue, was observed. The patient continues to be observed, and there has been no evidence of recurrence after 6 months’ of follow up. The adenomatoid hyperplasia pathogenesis remains unknown; however, clinicians should be aware of this condition, which may mimic a salivary gland neoplasm.

Evaluation of Proliferative Marker Ki-67 in Adenoid Cystic Carcinoma: A Retrospective Study

Adenoid cystic carcinoma (ACC) is a malignant tumor of salivary gland origin. Although the histologic appearance of ACC is low grade, management of this malignancy is a distinct therapeutic challenge because of its tendency for perineural involvement and potential for distant metastasis. Ki-67 antigen is expressed during the G1, S, G2 and M phases in the cell cycle but is absent in the quiescent G0 phase in tissue sections. Aim of the study was to review hematoxylin and eosin stained slides in order to confirm the previous histopathological diagnosis as per the criteria given by World Health Organisation (WHO) and to evaluate the expression of cell proliferation marker, Ki-67 antigen in Adenoid cystic carcinoma and correlate the expression of Ki-67 antigen histopathologically with different grades in Adenoid cystic carcinoma. Tissue samples of 32 cases (12 males and 20 females) were selected from minor salivary glands with age range from 21 to 70 years. Two paraffin-embedded sections of these total 32 cases each of 4 µm thick were cut on a rotary microtome. One section was stained using hematoxylin and Eosin (H&E) and the other was used for Immunohistochemical staining with Ki-67 antigen. Among these 32 cases of Adenoid cystic carcinoma, Histologically 14 (43.75%) tumors were classified in grade I, 8 (25%) were in grade II, and 10 (31.25%) were in grade III. The average percentage of Ki-67 expression was 27.12% in grade I, 34.43% in grade II and 38.45% in grade III. Ki-67 immunoreactivity increased with increase in histopathological grades of ACC. Since Ki-67 is a useful marker for assessing the proliferative potential of tumors, the prognosis of patients can definitely be predicted.

Sialadenoma Papilliferum Mimicking A Mucocele in A Young Patient: A Case Report

Sialadenoma papilliferum (SP) is a rare, benign neoplasm of salivary gland origin, which manifests as a painless, exophytic, papillary lesion, accounting for less than 1% of the minor salivary gland tumors. About 70% of the reported cases have occurred in the minor salivary gland of the palate, in middle-aged or older male patients. The present report aims to describe an unusual case of SP of the lower lip that mimicked a mucocele, in a 20-year-old woman. The clinical examination showed a nodular growth, measuring 3 × 1 cm, sessile, smooth-blue surfaced, slightly tender, with undetermined etiology. An excisional biopsy was performed and the histopathological examination revealed an exophytic papillary proliferation composed of well-differentiated stratified squamous epithelium, which merged with a glandular proliferation occupying the submucosa. Based on the clinical and histopathological findings, the final diagnosis was SP. Seven months of follow-up showed no recurrence.

Oral metastasis of renal cell carcinoma mimicking recurrence of excised malignant myoepithelioma: A case report.

Following breast and lung cancers, renal cell carcinoma (RCC) is the third most frequent cancer to metastasize to the head and neck region, though such cases are rarely reported. Distinguishing between malignant tumors of salivary gland origin and metastatic RCC is very important. The case of a 75-year-old man with an oral cavity lesion in the left buccal submucosa measuring 40×30 mm that had grown substantially over several weeks is presented. His medical history included left kidney cancer 26 years earlier and a malignant myoepithelioma of the left buccal region 7 years earlier. It was suspected that this lesion was a recurrent malignant myoepithelioma as it appeared at the same site as the previous operation. Surgery was performed, and metastatic RCC was confirmed upon pathological examination. The diagnosis of metastatic RCC was made by immunohistochemical examination, which also excluded malignant myoepithelioma and other clear cell carcinomas of salivary gland origin. Metastatic RCC must be considered in the differential diagnosis of a new oral cavity lesion presenting in a patient with a past history of kidney cancer. Thus, immunohistochemical staining is required to distinguish malignancies of salivary gland origin, including malignant myoepithelioma, from metastatic RCC.

HISTOPATHOLOGICAL CHARACTERISTICS OF PLEOMORPHIC ADENOMA; A RETROSPECTIVE ANALYSIS OF 120 CASES

Background: The salivary gland pleomorphic adenoma (PA) is a benign epithelial neoplasm, histologically characterized by a great diversity of morphological aspects. It is the most common neoplasm of salivary gland origin. Objective: Studying the histopathological characteristics of PA with special attention to the various morphological features of the epithelial cells and stromal components of this neoplasm. Methods: Hematoxylin and Eosin (H&E) stained tissue sections of 120 cases of PA were reviewed. The tumors were classified according to their histological subtypes as described by Seifert et al. The epithelial components were analyzed considering the type of cells and the morphological pattern. The stromal components were analyzed according to the presence of myxoid, hyaline, chondroid or calcified tissue. Results: This study revealed that most of the tumors were located in the parotid gland (44%). Myxoid or stroma-rich was the most frequent histological subtype (43%). Plasmacytoid cells were the most commonly seen epithelial component (100%), followed by cuboidal cells in (80%) of the cases. Trabecular pattern was the predominant epithelial morphological pattern (90 %), and the myxoid component was the most frequent stromal component (80%). Conclusion: PA of the salivary glands demonstrates a wide variety of cells, stromal components, and morphological characteristics. Since it is the most frequent salivary gland neoplasm that can resemble other salivary gland tumors, the knowledge about these variations is essential for a correct diagnosis. Keywords: Histopathology, pleomorphic adenoma, salivary gland neoplasms Citation: Sarkis SA, Al-Drobie BF, MajeedGH, Al-Marzooq TJM.Histopathological characteristics of pleomorphic adenoma; a retrospective analysis of 120 cases. Iraqi JMS. 2018; Vol. 16(1): 84-91. doi: 10.22578/IJMS.16.1.12

Hyalinizing clear cell carcinoma of salivary gland origin in the head and neck: clinical and histopathological analysis

Hyalinizing clear cell carcinoma (HCCC) is an extremely rare neoplasm of salivary gland origin with a low-grade indolent nature. It is difficult to distinguish from other malignant salivary gland tumours. Clinical outcomes following surgery are generally reported as good. The aim of this study was to further determine the features of HCCC. This study was approved by Medical ethics review of affiliated hospital of jiangsu university. Fourteen new cases of HCCC are reported. The clinical and histopathological data of these 14 cases were analysed alongside those of 141 cases identified in a systematic review of the literature (up to 2016). Demographic data, histopathological findings, clinical presentation, primary treatment, and outcomes were extracted. Histologically, HCCC tumour cells had a clear cell morphology with hyalinized stroma. Immunohistochemical results were positive for cytokeratins and EMA, but negative for SMA, S100, vimentin, and calponin. Twelve of the 14 patients showed EWSR1 translocation. Local nodal metastasis on presentation was present in 17.3% and the overall recurrence rate was 17.7% in the total population (N=155), compared with 35.7% and 21.4%, respectively, in the new cases alone. Focal necrosis and local metastasis were identified as possibly associated with recurrence. The overall prognosis was good: only 3.8% of patients died of the disease. HCCC is less indolent than was previously thought, but overall the prognosis is good. Risk factors for recurrence may include focal necrosis and local metastasis at presentation. The best treatment for patients with HCCC is wide local excision combined with regional lymph node dissection.

Canalicular adenoma: A systematic review

ObjectiveCanalicular adenoma (CA) is an uncommon but unique benign tumor of salivary gland origin. It is the third most common benign tumor of minor salivary glands, representing less than 1% of all salivary neoplasms. A systematic review is presented of reported cases of CA, to determine trends in presentation, diagnostic features, treatment, and patient outcome. MethodsSearches of specific databases, as reported, were carried out to identify papers reporting CA. The variables were patient symptoms, tumor location, histopathological findings, demographics, treatment, follow-up, and recurrence. Results430 cases were identified; the most common location was in the upper lip (66.3%), followed by hard palate (14.5%). The most common clinical presentation was a nodule (46.5%), followed by asymptomatic (29.5%), and discomfort (28.7%). CA was most frequently seen in females (64%). The average age was 66.3 years. 97% of cases were treated surgically. The average follow-up was 136.3 months, and recurrence was reported in 3% of the cases. ConclusionCA shows a strong predilection for the upper lip. CAs are frequently asymptomatic, but the principal symptom was pressure.

Parotid oncocytoma: diagnostic vs surgical dilemma

Oncocytomas are rare benign tumors of salivary gland origin, most often seen involving the parotid gland. They should be considered as a possible diagnosis in elderly patients with slow growing, nontender and mobile parotid swelling. We report here a middle aged female with left parotid swelling that was misdiagnosed on fine needle aspiration cytology and confirmed with histopathology report. Rarity of the disease with frequent cytologic overlaps and interpreter’s inexperience account for the majority of aspiration cytology pitfalls. Therefore, aspiration cytology alone may be misguiding at times, leading to surgical over-correction and further potential complications. The ever-changing trends of mucoepidermoid carcinoma (pre-operative, fine needle aspiration cytology), pleomorphic adenoma (intraoperative) and oncocytoma (post-operative, histopathology) have created diagnostic dilemma, confusion and challenged the surgical rationale. In cases with discrepancy between clinical, cytological and pathological reports, diagnostic as well as surgical dilemma exists wherein a thorough diagnostic re-assessment and a proper surgical revision is warranted.

Pleomorphic adenoma in the cheek a rare finding

Pleomorphic adenoma, also known as the benign mixed tumor is the most common tumor of salivary gland origin, accounting for about 60% of all salivary tumors. Up to 80% of tumors which occur in the parotid gland only, 10% in the submandibular glands, and the rest in the minor salivary glands. The pleomorphic adenoma comprises of the majority of both major and minor salivary gland tumors accounting for 3%–10% of neoplasms of head and neck region. The most common sites of pleomorphic adenoma of the minor salivary glands are the palate, followed by lips and then cheeks. These minor salivary gland pleomorphic adenomas require diagnosis based on clinical features and incisional biopsy should be avoided. These are managed by wide surgical excision. The recurrence of this tumor is a well-known factor, and inadequate initial surgical procedure is the most common cause of recurrence. Carcinoma arising from pleomorphic adenoma accounts for about 3% of salivary tumors. We are reporting a case of pleomorphic adenoma of minor salivary glands around the upper right buccal vestibule in a 36-year-old female.

Mucoepidermoid Carcinoma of Salivary Gland: Limitations and Pitfalls on FNA.

Mucoepidermoid Carcinoma (MEC) is the most common malignant neoplasm of salivary gland origin. However, its morphologic heterogeneity poses difficulty in interpretation. In the present series we discuss the morphologic features of MEC, limitations and pitfalls in its diagnosis on Fine Needle Aspiration Cytology (FNAC). Fourteen cases of suspected MEC were evaluated cytologically followed by histopathological examination for confirmation. A definite cytological diagnosis was rendered in nine cases; three of the remaining five were underdiagnosed as abscess, pleomorphic adenoma and mucus cyst. Of the remaining two cases, one case each of sebaceous carcinoma and sialadenitis was mislabeled as MEC on cytology. A satisfactory aspirate composed of intermediate cells, mucin secreting cells and squamous cells in a mucinous background may not be obtained in all cases of low grade MEC. High grade MEC can be classified as squamous cell carcinoma. Hence, awareness of confounding factors with clinicopathologic correlation and judicious use of frozen section can help in minimizing errors.

Adenoid cystic carcinoma of the skull base: results with an aggressive multidisciplinary approach.

OBJECT Adenoid cystic carcinoma (ACC) is a locally aggressive tumor of salivary gland origin. Little data exist to guide treatment when this tumor extends to involve the structures of the skull base. METHODS Fifty-one patients with a diagnosis of ACC affecting the skull base were identified from a prospective database at MD Anderson Cancer Center (from 1992 to 2010). RESULTS Median follow-up for study patients was 6.75 years. The 5- and 10-year overall survival (OS) rates were 78% and 50%, respectively. Sixty-six percent of patients had progression of their disease. The 5- and 10-year progression-free survival (PFS) rates were 46.7% and 21.0%, respectively. Gross-total resection was achieved in 75% of patients, with 49% having microscopically negative margins at the time of first operation. On univariate analysis, resections with microscopically negative margins were associated with a significant OS advantage (20.1 ± 3.3 years) compared with resections that left residual disease, even if microscopic (10.3 ± 1.6 years, p = 0.035). In patients who underwent reoperation, the effect persisted, with improved OS in those with negative margins (21.4 ± 0.0 vs 16.7 ± 4.0 years, p = 0.06). The use of adjuvant radiotherapy was associated with an OS advantage (16.2 ± 2.5 vs 5.5 ± 2.2 years, p = 0.03) at initial diagnosis and improved PFS (7.8 ± 1.0 vs 2.1 ± 0.62 years, p = 0.005), whereas repeat irradiation provided no benefit. The use of adjuvant chemotherapy at diagnosis or at recurrence was not associated with any significant advantage. Multivariate analysis revealed margin-negative resection at initial operation and at recurrence retained OS significance, even after controlling for age, radiation therapy, and T stage. CONCLUSIONS ACC of the skull base is best treated with a multidisciplinary approach aimed at maximal, safe resection. Adjuvant radiotherapy should be offered, whereas chemotherapy does not confer benefit.

Hyalinizing clear cell carcinoma of the head and neck: Case series and update.

Hyalinizing clear cell carcinoma (HCCC) is a rare neoplasm of salivary gland origin which is low-grade in nature. In this series, we report on 9 cases of HCCC and update the literature. A comprehensive literature search was performed. Our institutional database was queried for cases of HCCC. Pathology reports and slides were reviewed. Data was extracted, including demographics, staging, primary treatment, histopathologic findings, recurrence, and disease status. Statistical analysis was performed using a Pearson's chi-square test. One hundred thirty-six total cases were included for analysis. The overall recurrence rate was 19.8%. Necrosis was associated with risk of recurrence (p = .003). Positive margins and lymph node status were associated with risk of recurrence. Prognosis was good with only 3 of 82 patients reported dying with disease. HCCC has an overall good prognosis with potential for aggressive behavior. The presence of necrosis, locoregional disease, or positive margins is associated with risk for recurrence.

Adenoid Cystic Carcinoma of the Skull Base: Results with an Aggressive Multidisciplinary Approach

OBJECT Adenoid cystic carcinoma (ACC) is a locally aggressive tumor of salivary gland origin. Little data exist to guide treatment when this tumor extends to involve the structures of the skull base. METHODS Fifty-one patients with a diagnosis of ACC affecting the skull base were identified from a prospective database at MD Anderson Cancer Center (from 1992 to 2010). RESULTS Median follow-up for study patients was 6.75 years. The 5- and 10-year overall survival (OS) rates were 78% and 50%, respectively. Sixty-six percent of patients had progression of their disease. The 5- and 10-year progression-free survival (PFS) rates were 46.7% and 21.0%, respectively. Gross-total resection was achieved in 75% of patients, with 49% having microscopically negative margins at the time of first operation. On univariate analysis, resections with microscopically negative margins were associated with a significant OS advantage (20.1 ± 3.3 years) compared with resections that left residual disease, even if microscopic (10.3 ± 1.6 years, p = 0.035). In patients who underwent reoperation, the effect persisted, with improved OS in those with negative margins (21.4 ± 0.0 vs 16.7 ± 4.0 years, p = 0.06). The use of adjuvant radiotherapy was associated with an OS advantage (16.2 ± 2.5 vs 5.5 ± 2.2 years, p = 0.03) at initial diagnosis and improved PFS (7.8 ± 1.0 vs 2.1 ± 0.62 years, p = 0.005), whereas repeat irradiation provided no benefit. The use of adjuvant chemotherapy at diagnosis or at recurrence was not associated with any significant advantage. Multivariate analysis revealed margin-negative resection at initial operation and at recurrence retained OS significance, even after controlling for age, radiation therapy, and T stage. CONCLUSIONS ACC of the skull base is best treated with a multidisciplinary approach aimed at maximal, safe resection. Adjuvant radiotherapy should be offered, whereas chemotherapy does not confer benefit.

Mucoepidermoid Carcinoma Does Not Harbor Transcriptionally Active High Risk Human Papillomavirus Even in the Absence of the MAML2 Translocation

High risk human papillomavirus (HPV) is firmly established as an important cause of oropharyngeal carcinoma. Recent studies have also implicated HPV as a cause of mucoepidermoid carcinoma (MEC)-a tumor of salivary gland origin that frequently harbors MAML2 translocations. The purpose of this study was to determine the prevalence of transcriptionally active HPV in a large group of MECs and to determine whether HPV infection and the MAML2 translocation are mutually exclusive events. Break-apart fluorescence in situ hybridization for MAML2 was performed on a tissue microarray containing 92 MECs. HPV testing was performed using RNA in situ hybridization targeting high risk HPV mRNA E6/E7 transcripts. Of the 71 MECs that could be evaluated by FISH, 57 (80%) harbored the MAML2 rearrangement. HPV was not detected in any of the 57 MECs that contained a MAML2 rearrangement, in any of the 14 MECs that did not contain the rearrangement, or in any of the 21 MECs where MAML2 status was unknown. High risk HPV does not appear to play any significant role in the development of MEC. It neither complements nor replaces MAML2 translocation in the tumorigenesis of MEC.

Unicystic variant of low grade mucoepidermoid carcinoma: A rare case report

The most common malignant neoplasm of salivary gland origin is mucoepidermoid carcinoma (MEC), and it comprises of about 5-10% of all salivary gland neoplasm. It is mostly seen in major salivary glands (54%) and two third of them occurs in the parotid gland, and 46% is seen in minor salivary glands. Histo-morphological complexity of MEC has a constellation of varying amount of epidermoid cells, goblet cells, intermediate cells and mucocytes. It is graded histopathologically based on the relative proportion of cell type, cystic spaces, degree of tumor invasion, anaplasia, mitotic rates and presence or absence of necrosis into low-grade, Intermediate grade and high-grade. In the literature, several variants of MEC such as conventional, clear cell, warthin-like, sclerosing and unicystic variant have been reported. The aim of the current case report is to present a low-grade variant of unicystic MEC which is rare, but a distinctive tumor affecting the salivary gland. Till date, to the best of our knowledge only one case has been reported.

Oncocytoma of Parotid Gland: A Case Report with a Review of the Literature

Oncocytoma is a rare benign tumor of salivary gland origin, most often seen in the parotid gland. Oncocytoma is characterized by presence of large epithelial cell (oncocytes) with eosinophilic, finely granular cytoplasm and a rounded, centrally placed nucleus. They are most often encountered after the 6th decade of life. The clinical presentation of oncocytomas is essentially identical to other benign salivary gland tumors—a slow growing, nontender mass. They are firm, may be multilobulated and mobile on examination. Oncocytic neoplasms should be considered as a possible diagnosis in patients with parotid enlargement. This article describes a case of oncocytoma of parotid gland which was present in the 4th decade of life, with a brief review of the relevant literature. Due to the lack of large series, assiduous study of the cases reported in the literature may lead to better understanding of this rare disease.

Chondroid Syringoma of the Scalp: Case Report and Discussion of Clinical Features, Histopathology, and Treatment

Chondroid syringoma is a generally benign, adnexal tumor most commonly found in the head and neck. It is typically diagnosed retrospectively from histopathology, and careful evaluation must differentiate it from tumors of salivary gland origin. It presents as a slowly growing, subcutaneous or intradermal nodule. Treatment consists of wide local excision with a margin of normal tissue. We report a case involving a 51-year-old man with a chondroid syringoma arising from the scalp. Clinical features, histopathology, and treatment are discussed.