Eccrine Syringofibroadenoma Associated With Well-Differentiated Squamous Cell Carcinoma

Abstract

We report a case of an eccrine syringofibroadenoma (ESFA) associated with well-differentiated squamous cell carcinoma. The patient was an 85-year-old man, who had a 2.5x2.5-cm, brown-colored ulcerated nodule, with a fragile, flesh-colored bleeding surface located beyond the metacarpophalangeal joint of the second finger of his left hand. Histopathologically, there were areas of a well-differentiated squamous cell carcinoma, alternating with the typical area of ESFA characterized by anastomosing cords, strands, and columns of epithelial cells extending from the crusted epidermis into a thickened, edematous, myxoid vascular-rich dermis. Immunohistochemically, the areas with dysplastic epithelium were positive for p16, whereas the benign ESFA parts tested negative. Human papillomavirus was detected in the lesional tissue by polymerase chain reaction, and the subsequent sequencing analysis demonstrated that the virus was close to human papillomavirus type 107.

Syringometaplasia: variants and underlying mechanisms

“…Reactive eccrine syringofibroadenomatosis, which is microscopically characterized by anastomosing thin epithelial strands and cords with ductal structures in a fibrovascular stroma (Fig. ), is likely to reflect another reactive change in the eccrine glands that is believed to represent eccrine gland hyperplasia rather than metaplasia . It has been described in association with several conditions, including SCC, lichen planus, bullous pemphigoid, burns, trauma, and ulcers.…”

“…6), is likely to reflect another reactive change in the eccrine glands that is believed to represent eccrine gland hyperplasia rather than metaplasia. 10,[42][43][44][45] It has been described in association with several conditions, including SCC, lichen planus, bullous pemphigoid, burns, trauma, and ulcers.…”

Reactive Eccrine Syringofibroadenoma (ESFA) in Association With a Merkel Cell Carcinoma Excision Scar

“…4 One study suggested chronic actinic damage to be a cause of the carcinoma associated with ESFA. 19 Overall, the clinical course of reactive ESFA is benign, and the risk of malignant transformation is low. 9 Recurrences and metastasis have not been reported.…”

“…4 One study suggested chronic actinic damage to be a cause of the carcinoma associated with ESFA. 19…”

A solitary facial nodule with an uncharacteristic histopathology

“…ESFA has been associated with squamous cell carcinoma (SCC)[34567] and clear cell acanthoma (CCA) as one of the components in the dual tumor. The occurrence of ESFA with SCC has been more prevalent in literature, and the cases encountered have been summarized in Table 1.…”