Case of chondroid syringoma mimicking a nodular hidradenoma: A diagnostic pitfall on cytopathology

Abstract

1,2 Awareness of cytological features of these lesions is important to prevent misdiagnosis and consequently mismanagement of patients. | C ASE H I STOR YA 45-year-old male patient presented to us with complaints of a swelling over the lateral aspect of thigh since 10 years, slowly increasing in size. Physical examination revealed a firm non-tender lesion, measuring 5 3 4 cm 2 with restricted mobility.

Chondroid syringoma of the axilla: A potential for misdiagnosis as metastatic carcinoma on fine needle aspiration cytology

“…3 Since then, there have been few reports describing the cytologic features of chondroid syringoma (Table 1). [4][5][6][7][8][9][10][11][12][13][14][15][16][17] Cases diagnosed on FNAC have involved the head and neck region (particularly the scalp, nose, and lip), [6][7][8][9][10]16,17 extremities, 3,4,12,14,15 trunk, 11 and axilla. 5,13 Chondroid syringoma has been clinically mistaken for other types of skin lesions such as dermoid cyst, 7 sebaceous cyst, 10,17 epidermal inclusion cyst, 14 neurofibroma, 4 dermatofibroma, 17 and lipoma.…”

“…The hematoxylin-eosin stain shows encapsulated tumor composed of cystically dilated ducts, tubules, cords, and chondromyxoid stroma (4Â) or show predominantly one component, which can lead to diagnostic difficulties and misdiagnoses. 8,10,13,15 If the cellular component is predominant and has cytologic atypia, carcinomas with mucinous stroma and carcinosarcoma may be included in the differential diagnoses. 4,6,13,14 Carcinomas with mucinous stroma and carcinosarcoma can be easily distinguished due to obvious malignant features in the cellular component.…”

“…Sonogram shows a superficially located, 1 cm-sized oval hypoechoic mass in the right axilla syringoma may be difficult if it occurs in unusual sites and the typical biphasic cellular and chondromyxoid stromal elements are not visible in smears. 8,10,13,15 Herein, we report a case of chondroid syringoma of the axilla, assumed clinically to be a lymph node and initially misdiagnosed as a metastatic carcinoma by FNAC. This retrospective study used archived materials and did not affect patient care.…”

“…2 Since the first case of chondroid syringoma diagnosed by FNAC was reported by Masood and Hardy, 3 there have only been infrequent case reports describing the cytologic features of chondroid syringoma for diagnosis. [4][5][6][7][8][9][10][11][12][13][14][15][16][17] The characteristic feature of chondroid syringoma on cytology is the presence of distinct biphasic cell populations of epithelial and myoepithelial cells in the chondromyxoid stroma. 3 FNAC is a very useful tool for the diagnosis of chondroid syringoma when these cytologic findings are evident.…”

“…Skin adnexal tumors are rarely encountered on fine‐needle aspiration cytology (FNAC) because most clinicians prefer to diagnose suspected tumors through excision biopsy 2 . Since the first case of chondroid syringoma diagnosed by FNAC was reported by Masood and Hardy, 3 there have only been infrequent case reports describing the cytologic features of chondroid syringoma for diagnosis 4–17 . The characteristic feature of chondroid syringoma on cytology is the presence of distinct biphasic cell populations of epithelial and myoepithelial cells in the chondromyxoid stroma 3 .…”