Cutaneous cylindroma with malignant transformation

Abstract

Background. Malignant cutaneous cylindroma is a rare tumor. It has been described in 26 cases, both in the solitary form and in the autosomal dominant inherited multiple tumor form. The authors present two new cases that occurred in one family with a history of multiple cylindromas. Methods. Clinical and histopathologic data of both tumors were compared with those of 26 other cases in the literature. Immunohistochemical examinations were performed. Results. The malignant tumors were distinguished from the benign lesions by rapid growth, long‐standing ulceration, or bleeding. Histopathologic examination showed a well‐differentiated carcinoma in one patient and a poorly differentiated tumor in the other. In the latter, lymph node metastasis developed, and the patient died 2.5 years later. Histopathologic criteria of malignancy included cell pleomorphism, frequent mitoses and loss of jigsaw pattern, peripheral palisading, hyaline sheaths, and dual cell population. Conclusions. These observations are in accord with those in the literature. Malignant cutaneous cylindroma developed more often in the multiple tumor form than in the single tumor form. Malignant cylindroma is an aggressive carcinoma with a tendency to local destructive growth and metastases.

Clinical, Histological and Dermoscopic Findings in Familial Cylindromatosis: a Report of Two Cases

“…Although malignant transformation is very rare, there are reports of malignant transformation of dermal cylindromas and possibility of metastases to the lymph nodes, thyroid, liver, lungs and bones, causing hemorrhage and even meningitis (10). So far, less than 50 cases of cylindrocarcinomas have been reported in literature (14,10). However, patients with BSS are not only prone for malignant transformation of their cylindromas, but also for developing benign or malignant tumors in tissues other than skin appendages, particularly of the salivary glands (15).…”

Malignant Cylindroma of the Scalp Arising in a Setting of Multiple Cylindromatosis: A Case Report

“…Cylindromas are benign skin appendage tumors with two distinct clinical presentations, namely, solitary and multiple [2,3]. Solitary cylindromas occur most commonly on the skin of the head and neck and occur sporadically and typically are not inherited [3,4].…”

“…Multiple cylindromas are more common in females and occur over a wide age range, with majority of patients in second or third decades of life [3,6]. Malignant transformation of a solitary cylindroma is extremely rare and is somewhat more common, but unusual (33 cases reported) in patients with multiple lesions [2]. Characteristic clinical features indicating malignant change include rapid enlargement, increased tenderness, and change in color of a longstanding ulcerative lesion or bleeding [2,5,[7][8][9][10][11].…”

“…Malignant transformation of a solitary cylindroma is extremely rare and is somewhat more common, but unusual (33 cases reported) in patients with multiple lesions [2]. Characteristic clinical features indicating malignant change include rapid enlargement, increased tenderness, and change in color of a longstanding ulcerative lesion or bleeding [2,5,[7][8][9][10][11]. The malignant cylindroma is locally aggressive, often metastasizes, and requires careful long-term follow-up [2,4].…”

“…Characteristic clinical features indicating malignant change include rapid enlargement, increased tenderness, and change in color of a longstanding ulcerative lesion or bleeding [2,5,[7][8][9][10][11]. The malignant cylindroma is locally aggressive, often metastasizes, and requires careful long-term follow-up [2,4]. We report a rare case of malignant cylindroma arising in a patient with multiple cylindromatosis on the temporal region and discuss the histological and immunohistochemical features of this lesion.…”