Malignant chondroid syringoma of the skin: Magnetic resonance imaging features

Abstract

Skin tumours are usually divided into melanoma and non-melanoma types. Malignancies of the adnexal structures, of which sweat gland tumours are an example, are characterized under the non-melanoma types. Sweat gland malignancies are rare tumours that are usually associated with a poor prognosis. Given the rarity of these tumours, MRI findings of such tumours have not been described previously in the literature. We present a case report of an unusual malignant tumour of sweat gland origin known as a malignant chondroid syringoma of the skin with described MRI features. The MRI features are non-specific depicting intermediate signal intensity, changes on the proton density sequence and increased signal on the T2 and STIR-weighted sequences. Although these imaging features are characteristic of most soft tissue masses MRI can, in most cases, accurately depict the anatomic extent and identify tissue of origin, depth of invasion and relation to adjacent structures, such as muscles and bones. Thus high-resolution MRI of the skin in the future can be extremely helpful in characterizing and staging dermal neoplasms.

Malignant Chondroid Syringoma With Central Nervous System Involvement

“…1,4 The malignant variable, reported in the present case, constitutes a rare tumor lesion, 1Y5 originating mainly in the sweat glands, its malignancy commonly arising from its epitheleal component. 1,3,5 Its stroma is essentially fibrous and presents myxoid chondroid alterations. 1 Optical microscopy permits the observance of tubular epithelial cells that form nets or strings and keratinocyte cysts.…”

“…1 Histologically, owing to its mixed origin, it represents a lesion that is difficult to recognize, often being confused with basocellular carcinoma. 2,3 Owing to its histologic pleomorphism, the differentiation between the benign and malignant variables becomes difficult. 1,3,5 Its stroma is essentially fibrous and presents myxoid chondroid alterations.…”

“…Generally, it is larger than the benign form. 3 Complementation of the surgical treatment with radiotherapy is still controversial and does not present evidence in support of its routine use or even in relapse cases. 1 Different from the malignant type, it more often presents in men in their fourth decade of life, frequently involving the head and neck.…”

Benign chondroid syringoma of the orbit: a rare cause of exophtalmos

“…The MRI features are non-specific, but can accurately depict the anatomic extent and identify tissue of origin, depth of invasion and relation to adjacent structures, such as muscles and bones [10]. …”

Pleomorphic adenoma of the eyelid with apocrine gland origin; an atypical location

“…[1] Radiologic features are also nonspecific, although they can accurately show the extent and location of the lesion. [29] Histopathological and immunohistochemical analyses are essential for a definite diagnosis since they are characteristic for skin PA and permit a differential diagnosis with more frequent PA of the lacrimal gland.…”