Solitary dermal cylindroma: a rare case report

Abstract

Dermal cylindromas are rare benign skin appendageal tumors that has two clinical presentation, solitary and multiple form. The diagnosis is unusual. However, it must be considered in clinical practice.A 51-year-old woman hadpainless nodule on right arm. Skin examinatipn revealedtwo fragmented nodules, 1x0.5x0.5cm, tan to white, and rubbery. Histopathological findings revealed a well demarcated and an unencapsulated epithelial dermal tumor, composed of numerous oval and polygonal nests molded into a "jig-saw" or "mosaic" appearance at low power. The nests of cells were composed of basaloid cells with scant cytoplasm and hyperchromatic nuclei and paler cells at the center. Nests of epithelial cells were surrounded and penetrated by a thickened band of basement membrane material that was PAS-positive. Immunohistochemistry (IHC) staining with p63 showed positive staining on basaloid cells. Langerhans dendritic cells in the surrounding nests stained positive with CD1a. Solitary dermal cylindroma occurred sporadically in patients without family history of cutaneous cylindromas.Combination of morphologic, histochemystry and immunohistochemystry staining were needed for accurate diagnosis.

Solitary Dermal Cylindroma in an Uncommon Site: A Rare Case Report

“…According to Massoumi et al [ 11 ], hair follicle-covered areas are the potential sites, which are of follicular epithelial lineage, and they don't appear at the palm and sole of the hands and feet, respectively. This statement supports that these tumors are originating from hair follicles [ 11 , 12 ]. However, the histogenesis of cylindromas still remains uncertain despite the development of various immunohistological, histochemical, and ultrastructure studies.…”

“…Histopathologically, it has irregular islands and nested proliferation of tumor cells arranged in a ‘‘jigsaw" puzzle fashion. These cells have an eosinophilic pink material surrounding these epithelial cell nests [ 12 ]. These tumors typically have a biphasic cell population: peripherally located palisading cells that have a small dark nucleus, representing undifferentiated cells, and centralized differentiated cells having a medium- to large-sized pale nucleus, morphologically representing ductal or secretory cells [ 14 ].…”