Malignant chondroid syringoma: A case report and literature review

Introduction: Malignant mixed tumor of the skin/ malignant chondroid syringoma (MCS) is a very rare adnexal tumor that is considered as the malignant counterpart of the benign mixed tumor/benign chondroid syringoma (BSC) of the skin. It usually arises de novo in the extremities and takes an unpredictable clinical course with high incidence of local recurrence, distance metastasis, and death. We present a rare case of malignant chondroid syringoma of the forearm which metastasized to the axillary lymph node despite aggressive local treatment. Case Report: An 83-year-old male with history of numerous prior cutaneous neoplasms, presented with a forearm nodular keratotic lesion, clinically thought to be an invasive squamous cell carcinoma. Accurate histopathological examination revealed a completely excised malignant chondroid syringoma. The patient underwent wide local re-excision of the scar, followed by four weeks of local radiotherapy. Although there was no evidence of any local recurrence, he developed axillary lymph node metastasis four years after the initial diagnosis, for which he underwent axillary lymph node dissection. Pooja Vasudev1, Gabriela Gohla2, Samih Salama3, Salem Alowami3 Affiliations: 1Assistant Professor, Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Ontario, Canada; 2Associate Professor, Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Ontario, Canada; 3Professor, Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Ontario, Canada. Corresponding Author: Pooja Vasudev, Assistant Professor, Department of Pathology and Molecular Medicine, St. Joseph's Healthcare, L222-5, St Luke Wing, 50 Charlton Avenue East, Hamilton, ON L8N 4A6, Canada; Email: pooja.vasudev@medportal.ca Received: 27 August 2020 Accepted: 27 October 2020 Published: 07 December 2020 Conclusion: Malignant chondroid syringomas are exceedingly rare tumors, but with a high incidence of recurrence, metastasis, and death. These cases need to be diagnosed with strict histopathological criteria. Current treatment of MCS comprises of complete excision with wide margins plus or minus local radiotherapy to prevent local recurrence. Close follow-up and staging are recommended to aid in early detection of recurrence or metastasis.