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Dantas BC, Castro LR, Alves NSM, Swiczar BCC, Valente NYS. Pigmented eccrine syringofibroadenocarcinoma simulating malignant melanoma. An Bras Dermatol 2024; 99:625-628. [PMID: 38594176 DOI: 10.1016/j.abd.2023.03.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 03/18/2023] [Accepted: 03/21/2023] [Indexed: 04/11/2024] Open
Affiliation(s)
- Bianca Cristina Dantas
- Department of Dermatology, Hospital do Servidor Público Estadual, São Paulo, SP, Brazil.
| | - Luana Rytholz Castro
- Department of Dermatology, Hospital do Servidor Público Estadual, São Paulo, SP, Brazil
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2
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Reactive Eccrine Syringofibroadenoma (ESFA) in Association With a Merkel Cell Carcinoma Excision Scar. Am J Dermatopathol 2023; 45:137-141. [PMID: 36669080 DOI: 10.1097/dad.0000000000002334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 10/02/2022] [Indexed: 01/22/2023]
Abstract
ABSTRACT Eccrine syringofibroadenoma (ESFA) is a rare benign skin adnexal lesion of the acrosyringium of eccrine sweat ducts. Reactive ESFA, a subtype of ESFA, is usually associated with non-neoplastic cutaneous dermatoses or neoplastic skin tumors. Clinically, the lesions can be solitary or multiple, pink, or skin-colored coalescing papules or nodules of variable sizes. Histopathologically, this tumor is composed of numerous anastomosing cords of monomorphic cuboidal epithelial cells with eccrine duct formation. The association of reactive ESFA with benign conditions, such as psoriasis, diabetic polyneuropathy, scars, and leprosy, has been reported. However, the association of reactive ESFA with malignant tumors is extremely rare, with very few cases reported in the literature. We present a case of a 72-year-old woman who developed reactive ESFA associated with Merkel cell carcinoma excision scar. The ESFA tumors developed in the area of the surgical graft 10 months after the Merkel cell carcinoma had been excised. New ESFA tumors have continued to appear in the scar on a yearly basis while, so far, has been no recurrence of the original tumor. However, the presence of new tumor growths in the area suggested the possibility of recurrence of the Merkel cell carcinoma. That possibility was enhanced by the fact that PET scans revealed hypermetabolic activity in the ESFA papules.
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3
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Longstanding Eccrine Syringofibroadenoma With Evidence of Carcinomatous Transformation. Am J Dermatopathol 2021; 42:780-782. [PMID: 32271205 DOI: 10.1097/dad.0000000000001651] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Eccrine syringofibroadenoma (ESFA) is a cutaneous proliferation of eccrine ducts, mainly encountered in association with other dermatoses or skin tumors. Although a benign condition, either considered as a hamartoma or a reactive hyperplasia rather than a real neoplasm, some evidence suggests that longstanding ESFA can undergo malignant change. The recognition of such opportunity could have important therapeutic implications. We present a case of ESFA showing areas of carcinomatous transformation, discussing its morphological and immunohistochemical findings.
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4
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Current Diagnosis and Treatment Options for Cutaneous Adnexal Neoplasms with Apocrine and Eccrine Differentiation. Int J Mol Sci 2021; 22:ijms22105077. [PMID: 34064849 PMCID: PMC8151110 DOI: 10.3390/ijms22105077] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Revised: 04/15/2021] [Accepted: 05/02/2021] [Indexed: 12/16/2022] Open
Abstract
Adnexal tumors of the skin are a rare group of benign and malignant neoplasms that exhibit morphological differentiation toward one or more of the adnexal epithelium types present in normal skin. Tumors deriving from apocrine or eccrine glands are highly heterogeneous and represent various histological entities. Macroscopic and dermatoscopic features of these tumors are unspecific; therefore, a specialized pathological examination is required to correctly diagnose patients. Limited treatment guidelines of adnexal tumor cases are available; thus, therapy is still challenging. Patients should be referred to high-volume skin cancer centers to receive an appropriate multidisciplinary treatment, affecting their outcome. The purpose of this review is to summarize currently available data on pathogenesis, diagnosis, and treatment approach for apocrine and eccrine tumors.
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5
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Lee JS, Park H, Yoon HS, Cho S. Eccrine Syringofibroadenoma Associated with Bowen's Disease: A Case Report and Review of the Literature. Ann Dermatol 2020; 32:57-63. [PMID: 33911710 PMCID: PMC7992643 DOI: 10.5021/ad.2020.32.1.57] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Revised: 10/31/2018] [Accepted: 11/12/2018] [Indexed: 11/08/2022] Open
Abstract
Eccrine syringofibroadenoma (ESFA) is a rare, benign adnexal neoplasm which usually manifests as a solitary nodule on the extremities of elderly patients. Few case reports have described an association between ESFA and carcinomas including squamous cell carcinoma, porocarcinoma, and basal cell carcinoma. A 66-year-old male presented with a pruritic, erythematous brownish solitary plaque with crusted and verrucous surface on the extensor side of the right thigh. The lesion developed 6 to 7 years ago, and had been growing slowly. Biopsy revealed anastomosing epithelial strands which were composed of 2 areas: the upper area consisting of dysplastic cells with prominent nucleoli and abundant mitoses, and the lower area consisting of oval and round cells, and occasionally small luminal ducts. Dysplastic cells comprised almost the entire epidermis but did not invade into the dermis. Benign syringofibroadenomatous lesion surrounded the dysplastic cells in the lowermost portion of the epidermis. Although it is still unclear whether ESFA undergoes malignant transformation or it is a reactive change to carcinoma, complete excision should be performed to prevent malignant transformation with unknown risk.
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Affiliation(s)
- Ji Su Lee
- Department of Dermatology, SMG-SNU Boramae Medical Center, Seoul, Korea
| | - Hyunsun Park
- Department of Dermatology, SMG-SNU Boramae Medical Center, Seoul, Korea
| | - Hyun-Sun Yoon
- Department of Dermatology, SMG-SNU Boramae Medical Center, Seoul, Korea
| | - Soyun Cho
- Department of Dermatology, SMG-SNU Boramae Medical Center, Seoul, Korea
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6
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Wang L, Zhou P, Li F, Liu H. Solitary eccrine syringofibroadenoma of the dorsum of hand. Indian J Dermatol 2020; 65:560-561. [PMID: 33487730 PMCID: PMC7810092 DOI: 10.4103/ijd.ijd_331_18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
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7
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Commentary on Reactive Eccrine Syringofibroadenoma Associated With Basal Cell Carcinoma. Dermatol Surg 2017; 44:740-741. [PMID: 28961639 DOI: 10.1097/dss.0000000000001320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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8
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Lowell DL, Salvo NL, Weily WJ, Swiatek M, Sahli H. Multiple Eccrine Syringofibroadenoma of Mascaro of the Lower Extremity. J Am Podiatr Med Assoc 2016; 106:433-438. [PMID: 28033055 DOI: 10.7547/15-066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Eccrine syringofibroadenoma (ESFA) is a rare benign lesion of ductal and secretory differentiation exhibiting multiple cutaneous polymorphic presentations with an unknown etiology. We present a case of ESFA that uniquely exhibited large, thick, verrucous-like hyperplastic growths as well as superficial shiny mosaic plaques and deep ulcerations in three different anatomical locations in the same patient. The diagnosis of ESFA was confirmed histologically after biopsies were performed on all of the affected areas. In addition to a case report and literature review, we also present classification, clinical, and histologic aspects of ESFA.
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Affiliation(s)
- Danae L. Lowell
- Department of Surgery, Cleveland VA Medical Center, Cleveland, OH
| | - Nichol L. Salvo
- Young Physicians' Program, American Podiatric Medical Association, Bethesda, MD. Dr. Salvo is now with the Podiatry Section and Podiatry Residency Program, Atlanta VA Medical Center, Decatur, GA
| | | | - Michael Swiatek
- Private practice, Schwein Foot & Ankle Clinic, Mansfield, OH
| | - Hannah Sahli
- Kent State University College of Podiatric Medicine, Independence, OH
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9
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Bubna AK, Krishnamoorthy M, Gunabooshanam B. A Solitary Facial Nodule with an Uncharacteristic Histopathology. Int J Trichology 2016; 8:146-9. [PMID: 27625569 PMCID: PMC5007923 DOI: 10.4103/0974-7753.189022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Collision or contiguous tumors refer to the combined existence of two or more tumors in a single lesion. In the skin, these growths could closely mimic other cutaneous tumors, thus making diagnosis difficult. We hereby report a dual tumor, comprising pilomatricoma, and eccrine syringofibroadenoma, which to the best of our knowledge have not been previously reported in medical literature.
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Affiliation(s)
- Aditya Kumar Bubna
- Department of Dermatology, Sri Ramachandra University, Chennai, Tamil Nadu, India
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10
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Sirikham T, Rojhirunsakool S, Vachiramon V. Reactive Eccrine Syringofibroadenoma Associated with Neuropathy, Venous Stasis, and Diabetic Foot Ulcer. Case Rep Dermatol 2016; 8:124-9. [PMID: 27462220 PMCID: PMC4943312 DOI: 10.1159/000446469] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2016] [Accepted: 04/26/2016] [Indexed: 11/25/2022] Open
Abstract
Eccrine syringofibroadenoma (ESFA) is an uncommon benign adnexal neoplasm which derives from cells of the acrosyringium of eccrine sweat glands. The clinical appearance is nonspecific but the histological features are typical. Five clinical subtypes of ESFA exist: (1) solitary ESFA; (2) multiple ESFA associated with ectodermal dysplasia; (3) multiple ESFA without cutaneous features; (4) unilateral linear ESFA (nevoid), and (5) reactive ESFA associated with inflammatory or neoplastic dermatoses. We report the case of a 42-year-old man with long-standing diabetes and neuropathy, presenting with a 4-year history of asymptomatic erythematous plaques on a background of brown hyperpigmentation on the left foot. The clinical presentation and histopathological findings are compatible with reactive ESFA.
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Affiliation(s)
- Thirawut Sirikham
- Division of Dermatology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Salinee Rojhirunsakool
- Division of Dermatology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Vasanop Vachiramon
- Division of Dermatology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
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11
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Temnithikul B, Jerasutus S, Sudtikoonaseth P, Voravutinon N, Kootiratrakarn T, Kattipathananpong P. Eccrine syringofibroadenoma (ESFA): a report of two cases. Dermatol Pract Concept 2016; 6:5-8. [PMID: 26937300 PMCID: PMC4758438 DOI: 10.5826/dpc.0601a03] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2015] [Accepted: 10/06/2015] [Indexed: 11/28/2022] Open
Affiliation(s)
- Bhakinai Temnithikul
- Institute of Dermatology, Department of Medical Services, Ministry of Public Health, Bangkok, Thailand
| | - Suthep Jerasutus
- Department of Dermatology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Poonnawis Sudtikoonaseth
- Institute of Dermatology, Department of Medical Services, Ministry of Public Health, Bangkok, Thailand
| | - Nataya Voravutinon
- Institute of Dermatology, Department of Medical Services, Ministry of Public Health, Bangkok, Thailand
| | - Tanawatt Kootiratrakarn
- Institute of Dermatology, Department of Medical Services, Ministry of Public Health, Bangkok, Thailand
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12
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Bottino CB, Guimarães TF, Gomes FR, D'Acri AM, Lima RB, Martins CJ. Solitary eccrine syringofibroadenoma--Case Report. An Bras Dermatol 2016; 90:235-8. [PMID: 26312727 PMCID: PMC4540561 DOI: 10.1590/abd1806-4841.20153802] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2014] [Accepted: 08/04/2014] [Indexed: 11/22/2022] Open
Abstract
Eccrine syringofibroadenoma is a rare benign adnexal neoplasm derived from cells of
the acrosyringium of eccrine sweat glands. ESFA usually manifests as a solitary
nodule on the extremities of elderly patients, but it may also present as papules,
nodules or plaques. Its clinical appearance is nonspecific and malignant neoplasms
should beconsidered in the differential diagnosis. However, histopathological
findings are typical. The main treatment is surgical excision. In order to illustrate
a typical presentation of the tumor, we report a case of solitary eccrine
syringofibroadenoma, including the surgical treatment used and its result.
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13
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Arora P, Bansal S, Garg VK, Khurana N, Lal B. Solitary eccrine syringofibroadenoma with nail involvement: A rare entity. Indian J Dermatol 2015; 60:103. [PMID: 25657422 PMCID: PMC4318028 DOI: 10.4103/0019-5154.147847] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Eccrine syringofibroadenoma (ESFA) is a rare, benign tumor of eccrine sweat gland origin that usually presents as a nodule on the extremities of an elderly person. It can also present as an ulcerative plaque, verrucous lesion, papular or nodular lesion or as palmoplantar keratoderma. Although the clinical features are variable, histology is characteristic in the form of anastomosing strands, cords and columns of epithelial cells embedded in a fibrovascular stroma. We report the case of a 62-year-old male with a nodular lesion on the extremity that caused secondary involvement of the nail in the form of complete nail dystrophy. The histology showed features consistent with ESFA. Nail involvement by ESFA is a rare presentation and is rarely described in the literature.
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Affiliation(s)
- Pooja Arora
- Department of Dermatology, Maulana Azad Medical College and Lok Nayak Hospital, New Delhi, India
| | - Shuchi Bansal
- Department of Dermatology, Maulana Azad Medical College and Lok Nayak Hospital, New Delhi, India
| | - Vijay Kumar Garg
- Department of Dermatology, Maulana Azad Medical College and Lok Nayak Hospital, New Delhi, India
| | - Nita Khurana
- Department of Pathology, Maulana Azad Medical College and Lok Nayak Hospital, New Delhi, India
| | - Brahmanand Lal
- Department of Surgery, Maulana Azad Medical College and Lok Nayak Hospital, New Delhi, India
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14
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Study of Squamous Cell Carcinoma Associated With Syringofibroadenoma for 105 Types of Human Papillomavirus and for all Currently Known Types of Polyomaviruses. Appl Immunohistochem Mol Morphol 2014; 22:e41-4. [DOI: 10.1097/pai.0b013e318244ff6a] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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15
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Morganti AG, Martone FR, Macchia G, Carbone A, Massi G, De Ninno M, Deodato F, Picardi V, Sallustio G, Tulli A, Amerio P. Eccrine syringofibroadenoma radiation treatment of an unusual presentation. Dermatol Ther 2010; 23 Suppl 1:S20-3. [PMID: 20136917 DOI: 10.1111/j.1529-8019.2009.01282.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Benign skin diseases have seldom been treated with radiotherapy, unless resistant to other treatments. Eccrine syringofibroadenoma (ESFA) is a rare benign eccrine tumor. ESFA very rarely presents bilateral lesions, and seldom a nonsurgical treatment has been proposed. An exceptional case of bilateral ESFA of the foot is presented; radiotherapy was effective in treating both lesions with good cosmetic results.
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Affiliation(s)
- Alessio G Morganti
- Department of Oncology, Catholic University of Sacred Heart, Largo Agostino Gemelli, Campobasso, Italy
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Tey HL. Characterizing the nature of eccrine syringofibroadenoma: illustration with a case showing spontaneous involution. Clin Exp Dermatol 2009; 34:e66-8. [PMID: 19438523 DOI: 10.1111/j.1365-2230.2008.03179.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Eccrine syringofibroadenoma (ESFA) is a histological entity. It has been widely debated as to whether ESFA is a true neoplasm, a hamartoma or a form of reactive hyperplasia. ESFA should not be considered a homogenous condition and there are five clinical subtypes: (i) multiple ESFA associated with ectodermal dysplasia, (ii) multiple ESFA without cutaneous features (both hamartomatous), (iii) unilateral linear ESFA (naevoid), (iv) solitary ESFA (neoplastic) and (v) reactive ESFA, which seems to start off as pathologically hyperplastic and then become hamartomatous. We report a patient with reactive ESFA secondary to lepromatous leprosy, showing spontaneous involution in an area of her lesions. Reactive ESFA represents a hyperplastic and hamartomatous process, and may be more appropriately known as reactive eccrine syringofibroadenomatosis. The risk of malignancy is low in reactive ESFA, and monitoring instead of excision is a reasonable option.
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Affiliation(s)
- H L Tey
- National Skin Centre, Singapore.
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17
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Eccrine Syringofibroadenoma Associated With Well-Differentiated Squamous Cell Carcinoma. Am J Dermatopathol 2008; 30:572-4. [DOI: 10.1097/dad.0b013e31817d4c90] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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18
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Mattoch IW, Pham N, Robbins JB, Bogomilsky J, Tandon M, Kohler S. Reactive eccrine syringofibroadenoma arising in peristomal skin: An unusual presentation of a rare lesion. J Am Acad Dermatol 2008; 58:691-6. [PMID: 18342718 DOI: 10.1016/j.jaad.2007.08.032] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2007] [Revised: 07/26/2007] [Accepted: 08/28/2007] [Indexed: 10/22/2022]
Abstract
We report the third case of eccrine syringofibroadenoma (ESFA) arising in peristomal skin. A 55-year-old man presented with a 15- x 10-cm pale pink verrucous, exophytic, intermittently tender plaque involving his ileostomy site. He had undergone proctocolectomy with ileostomy creation 33 years prior for ulcerative colitis. The clinical differential diagnosis included granulomatous dermatitis, infection (fungus or atypical mycobacterium), or neoplasm. A punch biopsy specimen was performed and showed ESFA. Although ESFA is considered to be benign, recent reports have demonstrated an association of ESFA with malignancy or malignant transformation of ESFA. Furthermore, ESFA and reported cases of ileostomy carcinoma share similar clinical symptoms at presentation including pain, irritation, ulceration, bleeding, and the presence of a fungating mass. The lesion was, therefore, excised in toto and the excisional specimen showed no evidence of malignancy. We speculate that ESFA is a reaction to chronic irritation and, analogous to other long-standing reactive processes such as lichen sclerosis or burn scar ulcers, may be associated with malignant transformation. Because of this possibility and the clinical overlap with ileostomy carcinoma, peristomal ESFA should be treated with complete excision. If it is not amenable to complete excision because of lesion size or anatomic complexity, generous sampling and close clinical follow-up are recommended.
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Affiliation(s)
- Ingerlisa W Mattoch
- Department of Pathology, Stanford University Medical Center, Stanford, California 94305, USA.
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Schadt CR, Boyd AS. Eccrine syringofibroadenoma with co-existent squamous cell carcinoma. J Cutan Pathol 2007; 34 Suppl 1:71-4. [DOI: 10.1111/j.1600-0560.2007.00740.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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20
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Abstract
Eccrine syringofibroadenoma of Mascaro is a rare benign tumour. There are five subtypes, one of which is known to occur in reaction to inflammatory and neoplastic dermatoses. We describe a patient with previous lepromatous leprosy presenting with multiple flesh-coloured verrucous plaques over the right foot. Histology was consistent with eccrine syringofibroadenoma. To our knowledge, this is the first reported case of multiple eccrine syringofibroadenomata occurring in association with leprosy. The tumours in this case are most likely reactive in nature, subsequent to multiple traumatic events with tissue remodelling in an insensate foot affected by leprosy. It is less probable that the tumours are a result of scarring from recurrent infections. We also raise the possibility of a neuroeccrine interaction, with sympathetic neuropathy in leprosy as a contributing factor in the pathogenesis.
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Affiliation(s)
- H L Tey
- National Skin Center, Singapore.
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