Eccrine syringofibroadenoma surrounding a squamous cell carcinoma: A case report

Abstract

A 91-year-old man presented with a 9.0 x 7.0 cm exophytic mass on the dorsum of the right foot, surrounded by a scaling hyperkeratotic plaque-like lesion that had been present for many years. He had similar long-standing hyperkeratotic plaque-like lesions on both legs. Histopathologic examination of the exophytic mass revealed a well-differentiated squamous cell carcinoma surrounded by an eccrine syringofibroadenoma (ESFA). Histochemistry, immunohistochemistry and electron microscopy support this diagnosis. To our knowledge, this is the only reported case of ESFA being intimately associated with a malignant neoplasm.

Reactive eccrine syringofibroadenoma arising in peristomal skin: An unusual presentation of a rare lesion

“…54 In the limited reports available, complete excision appears to be the appropriate treatment for ESFA associated with or exhibiting malignant features. [15][16][17][18] In summary, we report a case of ESFA arising in peristomal skin. In this location, given the chronic manipulation and exposure of tissue to gastrointestinal and chemical irritants, ESFA is most likely reactive in nature.…”

“…15,16,18 In reviewing the reported cases, J AM ACAD DERMATOL VOLUME 58, NUMBER 4 the following unifying features were identified: (1) patients were, on average, in their eighth decade; (2) male patients were affected more than female patients; (3) all cases involved the extremities; and (4) all cases showed worrisome features including inflammation, new growth, ulceration and crusting, and persistent disease despite extensive treatment. Notably, reported cases of peristomal carcinoma presented with similar symptoms.…”

“…3,7 Until recently, ESFA was considered to have an entirely benign clinical course. 2,3 However, recent reports have demonstrated an association of ESFA with squamous cell carcinoma or apparent malignant transformation of ESFA, [15][16][17][18] with the proposed term ''eccrine syringofibroadenocarcinoma.'' 17 The histologic features of ESFA are diagnostic and include multiple thin anastomosing cords and strands of benign-appearing, cuboidal epithelial cells that form a lattice that is connected to the undersurface of the epidermis and embedded in a loose fibrovascular stroma.…”

“…2,3 However, recent reports suggest the possibility of an association of ESFA with squamous cell carcinoma or malignant transformation of ESFA. [15][16][17][18] In this study, we report the third case of peristomal ESFA, describe the clinical and histopathologic findings, and emphasize the potential for malignant change in these lesions.…”

Eccrine Syringofibroadenoma Associated With Well-Differentiated Squamous Cell Carcinoma

“…[2][3][4][5][6][7][8][9][10][11][12][13] Carcinoma arising in the background of ESFA is a rare event, with 10 cases reported to date. [14][15][16][17][18][19] Most tumors represented well-differentiated SCC. In this article, we report a case of ESFA associated with SCC, which additionally manifested cytopathic changes suggestive of human papillomavirus (HPV) infection; molecular biologic studies identified HPV DNA in the lesional tissue.…”