Spinal cord compression secondary to metastasis of malignant chondroid syringoma: case report

Abstract

<jats:p>The authors describe a case of spinal cord compression due to an epidural metastasis of malignant chondroid syringoma. Chondroid syringoma is a rare mixed tumor of the skin composed of both epithelial and mesenchymal elements. Although most are benign, malignant forms have been reported. Malignant chondroid syringoma may progress very slowly and the metastatic spread occurs late, appearing years after the original diagnosis. There is only one other report of spinal cord compression secondary to metastasis of malignant chondroid syringoma, which was finally diagnosed by microscopic examination of an autopsy specimen.</jats:p> <jats:p>This 63-year-old woman presented with a 4-week history of progressive paraparesis. Admission MRI of the thoracic spine showed an extradural mass arising from the posterior elements and left pedicle of T-9, which caused posterior compression of the spinal cord. Surgical decompression resulted in resolution of the neurological impairments. The histological results were consistent with metastasis of malignant chondroid syringoma. The patient underwent adjuvant radiotherapy and a favorable outcome was noted at the 2-year follow-up visit. This represents the first reported case of spinal cord compression from a metastasis of a malignant chondroid syringoma histologically confirmed in vivo. The authors' experience in this case suggests that resection followed by radiotherapy might be an acceptable means for achieving short-term, progression-free survival.</jats:p>

Surgery associated with radiotherapy in patients affected by metastatic medular compression: scientific production of the health area

“…After the discovery of neurological compression at T8-9, a laminectomy was performed, the mass was removed, and the medulla decompressed. Therefore, liver and kidney metastases were discovered 14 and 15 years after removal of the primary spinal tumor and 21 years after excision of the skin tumor 19 .…”

Malignant chondroid syringoma of the pinna

“…For malignant CS, the initial treatment modality is aggressive surgery aimed at achieving negative margins. [ 6 7 8 9 ] Adjuvant radiotherapy, with or without chemotherapy have been used but with limited success. [ 7 8 ]…”

Local recurrence of cutaneous mixed tumor (chondroid syringoma) as malignant mixed tumor of the thumb 20 years after initial diagnosis

“…Cutaneous mixed tumor (also known as "chondroid syringoma", although this is an older term which has fallen out of favor), is a benign appendageal tumor of the eccrine or apocrine glands consisting of both epithelial and mesenchymal elements. 1,2 The incidence of cutaneous mixed tumor is rare, composing <0.01% of all primary skin tumors. 3 The malignant counterpart is even more rare, and these malignant adnexal neoplasms typically lack distinctive clinical features.…”