A diagnostic challenge. 2016

D Ismail, and G Langman, and S D Orpin
Department of Dermatology, Dudley NHS Foundation Trust, West Midlands, United Kingdom. dinawismail@gmail.com.

A 74 year-old woman presented with a 9 month history of a slowly enlarging exophytic lesion over her left nasal alar. Examination revealed a firm, cystic mass fixed to underlying skin. It was pedunculated with occasional superficial telangiectasia and a violaceous hue. A differential diagnosis of dermoid or sebaceous cyst, dermatofibroma, and neurofibroma was considered. Histopathological examination confirmed the rare diagnosis of chondroid syringoma (CS), which has a reported incidence of 0.01- 0.098% of excised skin tumors. It is unusual for CS to present in an elderly woman, as these benign primary skin tumors normally present in adult males. Dermoscopy does not reveal any specific features and the diagnosis is difficult to make based on clinical examination alone.

UI MeSH Term Description Entries
D008949 Adenoma, Pleomorphic A benign, slow-growing tumor, most commonly of the salivary gland, occurring as a small, painless, firm nodule, usually of the parotid gland, but also found in any major or accessory salivary gland anywhere in the oral cavity. It is most often seen in women in the fifth decade. Histologically, the tumor presents a variety of cells: cuboidal, columnar, and squamous cells, showing all forms of epithelial growth. (Dorland, 27th ed) Mixed Salivary Gland Tumor,Salivary Gland Tumor, Mixed,Syringoma, Chondroid,Adenomas, Pleomorphic,Chondroid Syringoma,Chondroid Syringomas,Pleomorphic Adenoma,Pleomorphic Adenomas,Syringomas, Chondroid
D009455 Neurofibroma A moderately firm, benign, encapsulated tumor resulting from proliferation of SCHWANN CELLS and FIBROBLASTS that includes portions of nerve fibers. The tumors usually develop along peripheral or cranial nerves and are a central feature of NEUROFIBROMATOSIS 1, where they may occur intracranially or involve spinal roots. Pathologic features include fusiform enlargement of the involved nerve. Microscopic examination reveals a disorganized and loose cellular pattern with elongated nuclei intermixed with fibrous strands. (From Adams et al., Principles of Neurology, 6th ed, p1016) Neurofibromas
D009669 Nose Neoplasms Tumors or cancer of the NOSE. Cancer of Nose,Nasal Neoplasms,Nose Cancer,Cancer of the Nose,Nasal Cancer,Neoplasms, Nose,Cancer, Nasal,Cancer, Nose,Cancers, Nasal,Cancers, Nose,Nasal Cancers,Nasal Neoplasm,Neoplasm, Nasal,Neoplasm, Nose,Neoplasms, Nasal,Nose Cancers,Nose Neoplasm
D003937 Diagnosis, Differential Determination of which one of two or more diseases or conditions a patient is suffering from by systematically comparing and contrasting results of diagnostic measures. Diagnoses, Differential,Differential Diagnoses,Differential Diagnosis
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly
D012878 Skin Neoplasms Tumors or cancer of the SKIN. Cancer of Skin,Skin Cancer,Cancer of the Skin,Neoplasms, Skin,Cancer, Skin,Cancers, Skin,Neoplasm, Skin,Skin Cancers,Skin Neoplasm
D013544 Sweat Gland Neoplasms New abnormal growth of tissue in the SWEAT GLANDS. Neoplasms, Sweat Gland,Neoplasm, Sweat Gland,Sweat Gland Neoplasm
D018219 Histiocytoma, Benign Fibrous A benign tumor composed, wholly or in part, of cells with the morphologic characteristics of HISTIOCYTES and with various fibroblastic components. Fibrous histiocytomas can occur anywhere in the body. When they occur in the skin, they are called dermatofibromas or sclerosing hemangiomas. (From DeVita Jr et al., Cancer: Principles & Practice of Oncology, 5th ed, p1747) Dermatofibroma,Hemangioma, Sclerosing,Histiocytoma, Cutaneous,Histiocytoma, Fibrous,Angioma, Sclerosing,Benign Fibrous Histiocytoma,Angiomas, Sclerosing,Benign Fibrous Histiocytomas,Cutaneous Histiocytoma,Cutaneous Histiocytomas,Dermatofibromas,Fibrous Histiocytoma,Fibrous Histiocytoma, Benign,Fibrous Histiocytomas,Fibrous Histiocytomas, Benign,Hemangiomas, Sclerosing,Histiocytomas, Benign Fibrous,Histiocytomas, Cutaneous,Histiocytomas, Fibrous,Sclerosing Angioma,Sclerosing Angiomas,Sclerosing Hemangioma,Sclerosing Hemangiomas

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