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Hosp Aeronáut Cent 2012; 7(2): 124-126
Siringoma Condroide Maligno: a Propósito de un Caso
Malignant chondroid syringoma: Case Report
Gustavo Wasielewsky*, My. (E. Med.) Rubén D. Algieri**, 1er Ten. (E. Med.) Benjamin Nowydwor***, 1er
Ten. ”e.c.” (E. Med.) Felix Viglione****, 1er Ten. “e.c.” (E. Med.) Fabiana Franco Alanis****, 1er Ten. “e.c” (E.
Med.) Cristian Flores****
Workplace:
- General Surgery Service. Hospital Aeronáutico Central. 3697, Ventura de la Vega Street, City of Buenos Aires.
* Surgeon, General Surgery Service, Hospital Aeronáutico Central
** Head of the General Surgery Service, Hospital Aeronáutico Central.
*** General Surgery Chief Resident. Hospital Aeronáutico Central.
**** General Surgery Resident. Hospital Aeronáutico Central.
Resumen
Abstract
Introducción: El siringoma condroide maligno es un tumor
Introduction: Although the malignant chondroid syringoma is a
cutáneo muy infrecuente pero que debemos tener en cuenta en
very rare skin tumor, it must be considered in the differential
el diagnóstico diferencial de los tumores axilares.
diagnosis of axillary tumors.
Objetivos: Se realiza el análisis y la presentación del siguiente
Objectives: The following clinical case is analyzed and presented
caso clínico con el objetivo de considerar esta entidad como
in order to consider this entity as differential diagnosis of axillary
diagnostico diferencial de los tumores axilares.
tumors.
Presentación de Caso: Paciente de sexo femenino de 82 años
Case Report: 82 year-old, female patient who presents with a
que refiere la presencia de una tumoración cutánea en axila
skin tumor of 3 years evolution in the right axilla. Biopsy (PUNCH)
derecha de 3 años de evolución, con realización de biopsia
reports infiltration due to moderately differentiated carcinoma.
(PUNCH) que informa infiltración por carcinoma moderadamente
Surgical extirpation is decided.
diferenciado. Se decide su exéresis quirúrgica.
Discussion: The malignant chondroid syringoma is a rare tumor,
Discusión: El siringoma condroide maligno es un tumor
but can metastasize, with extended survival times. It prefers limbs
infrecuente, pero puede dar metástasis, pero con prolongados
and trunk.
tiempos de sobrevida. Prefiere las extremidades y el tronco.
Its prognosis is good when the extirpation is complete, but
Su pronóstico es bueno cuando la exéresis es completa, aunque
patients must be followed-up anyway.
es necesario realizar un seguimiento completo de los pacientes.
Palabras clave: Siringoma Condroide Maligno. Tratamiento
quirúrgico
Received: October 9th, 2012. Accepted: November 11th, 2012
124
Keywords: Malignant chondroid syringoma. Surgical treatment.
Wasielewsky et al, Hosp Aeronáut Cent 2012; 7(2): 124-126
thoracoabdominal
Introduction
tomography).
Both
the
tomography and the ultrasound show images
The usually called “chondroid syringoma” is
compatible with adenopathies in the right under
considered a rare pathological entity affecting
arm area.
mainly glandular processes
1,2,6
. It is extremely
The surgical procedure is carried out (tumor
malignant. As regards its location, it is most
resection plus right axillary emptying). The results
commonly found, in 80% of cases, on the head
of the pathological anatomy showed skin mixed
and neck (nose, cheek, upper lip, hairy skin and
tumor (malignant
forehead); this location is followed, in 10% of
axillary nodal metastases (17/17).
cases, by the trunk and limbs and, less frequently,
It is submitted to the tumor committee where
it can affect the feet, axillary region, abdomen,
progress monitoring and a new assessment to
penis, vulva and scrotum. It presents as a slow-
start radiation therapy and chemotherapy are
growing asymptomatic nodule which may develop
decided.
metastasis over time.
chondroid
syringoma) with
2,8,9
It is difficult to diagnose the chondroid syringoma
before performing the biopsy, and its result may
not be definitive since this is a tumor made up of
two very different parts. The final diagnosis is
provided
by
the
immunohistochemical
histopathological
and
examination
the
of
complete tumor piece and differential diagnosis
must be performed against similar entities such as
mioepithelium,
chondroid
fibromyxoid tumor.
3,4,6
choristoma
or
PHOTO 1: Growing and palpable axillary tumor
Objectives
To highlight the finding of this rare tumor including
it within the differential diagnoses of axillary
tumors.
Case Report
82-year-old female patient who makes reference
to the presence of a cutaneous tumor of 3 years
evolution in her right axilla. Biopsie (PUNCH)
reports infiltration due to moderately differentiated
PHOTO 2: Resection of surgical piece
carcinoma. Surgical extirpation is decided.
Several complementary studies are carried out
(breast
ultrasound,
Revista del Hospital Aeronáutico Central
mammography,
125
Siringoma Condroide Maligno: a Propósito de un Caso
Discussion
References
The names “chondroid syringoma” and “mixed
1. Burgesser MV, Metrebian MF, Kuurpis M, Diller A,
tumor” have been used as synonyms; whenever it
Neoplasias de la piel. Revisión Histopatológica de 8 años
is located in the salivary gland it is called
pleomorphic adenoma.1,2,5,7
de experiencia, Rev. Argentina Dermatología 2009; 90: 152164.
2. Carlos Álvarez Mora, Héctor Ricardo Lara Torres, Antonio
This type of tumor is rarely found outside the
Ysita Morales, Siringoma condriode: a propósito de dos
salivary glans, but that may sometimes happen3,4.
casos y revisión de la bibliografía. patología Revista
Although the benign mixed tumor of the skin is
latinoamericana Volumen 48, núm. 2, abril-junio, 2010:100104.
relatively frequent, the chondroid syringoma is
3. Casteleiro Roca, P., Vázquez Barro, A., Comellas Franco,
extremely rare. It is more common in women
M, Pombo Otero, J., Martelo Villar, F, Siringoma condroide
(women: men 3:2); it is more frequently found in
maligno: a propósito de un caso, Cir.plást. iberolatinoam. -
trunk and limbs than in head and neck. Often, it is
Vol. 35 - Nº 1 Enero - Febrero - Marzo 2009 / Pag. 73-78.
4. Jiménez HF y cols. Siringoma condroide, Rev Cent
bigger than the benign form and presents as a
Dermatol Pascua, Vol. 18, Núm. 2, May-Ago 2009: 62-63.
firm, unique, subcutaneous, slow-growing, simple
5. Ogawa R, Mitsuhashi K, Oki K, et al. A rare case of
or multiple asymptomatic nodule. It may develop
metastasis but has extended survival times.
Unlike the benign variety, it prefers limbs and
chondroid
syringoma arising from the lower eyelid with
ectropion. Plast Reconstr Surg 2006;118(6):137-140
6. Ollague-Torres JM, Vera ME, Neoplasias de las glándulas
sudoríparas, Dermatología Perú. 2005;15(2):211-221.
trunk. It is difficult to diagnose the chondroid
7. Torres S, Gutiérrez T, Navarrete G, et al. Siringoma
syringoma before performing the biopsy, and its
condroide. Presentación de dos casos. Rev Cent Dermatol
result may not be definitive since this is a tumor
made up of two very different parts.
The
final
diagnosis
histopathological
and
is
provided
by
the
immunohistochemical
examination of the complete tumor piece and it is
performed through exclusion against other entities
such as mioepithelium, chondroid choristoma,
fibromyxoid tumor, sebaceous cyst, implantation
dermoid, neurofibroma, dermatofibroma, basal
cell
carcinoma,
squamous
cell
carcinoma,
pilomatrixoma or histiocytoma.
The malignant chondroid syringoma is a very
unfrequent cutaneous tumor with a very low
incidence; however, it must be considered in the
differential diagnosis of axillary tumors since it has
a good prognosis when the “complete excision” is
performed. In spite of that, the patient must be
strictly followed
126
1,2,6,7,8
.
Pascua 2007;16(1):30-33