Ahorro Alyssa Francesca, Huang Jack, Weyer Christopher, Moenster Jamie M
School of Osteopathic Medicine, University of the Incarnate Word, San Antonio, USA.
Department of Pathology, Tucson Pathology Associates, Tucson, USA.
Cureus. 2025 Feb 6;17(2):e78623. doi: 10.7759/cureus.78623. eCollection 2025 Feb.
Chondroid syringomas are rare adnexal neoplasms composed of epithelial and mesenchymal components, posing diagnostic challenges due to their diverse histological features. We report an atypical presentation of an apocrine mixed tumor in a 51-year-old female patient who presented with a 0.7 cm firm, flesh-colored nodule on the right lateral cutaneous lip. The patient's clinical findings included significant actinic damage, such as dyschromia, elastosis, lentigines, and actinic keratoses, indicative of chronic sun exposure. Over four months, the lesion increased in size to 1.7 cm x 1.2 cm, warranting surgical excision. Histopathological analysis revealed a cutaneous adnexal neoplasm with follicular and apocrine differentiation, consistent with a chondroid syringoma. The tumor exhibited the characteristic chondromyxoid stroma with areas of myxoid and chondroid components. Mohs micrographic surgery was performed, ensuring complete tumor removal while sparing healthy tissue. A rotational flap closure provided an excellent esthetic and functional outcome, with minimal scarring and no functional impairments reported during follow-up. This case highlights the diagnostic and therapeutic challenges associated with chondroid syringomas, particularly in atypical locations such as the cutaneous lip. The coexistence of chronic photodamage further complicates the clinical picture, emphasizing the importance of thorough histopathological evaluation. Despite the tumor's rarity, timely surgical intervention and meticulous wound management yielded a favorable prognosis. This report underscores the need for clinician awareness to facilitate early diagnosis and appropriate management of rare cutaneous neoplasms, with follow-up care recommended to monitor for potential recurrence.
软骨样汗腺腺瘤是一种罕见的附属器肿瘤，由上皮和间充质成分组成，因其多样的组织学特征而带来诊断挑战。我们报告了一名51岁女性患者的大汗腺混合瘤的非典型表现，该患者右侧唇部外侧出现一个0.7厘米大小、质地坚硬、肉色的结节。患者的临床检查结果包括明显的光化性损伤，如色素沉着异常、弹性组织变性、雀斑和光化性角化病，提示长期日晒。在四个月的时间里，病变增大至1.7厘米×1.2厘米，需要进行手术切除。组织病理学分析显示为一种具有毛囊和大汗腺分化的皮肤附属器肿瘤，符合软骨样汗腺腺瘤。肿瘤呈现出特征性的软骨黏液样基质，伴有黏液样和软骨样成分区域。进行了莫氏显微外科手术，确保在保留健康组织的同时完全切除肿瘤。采用旋转皮瓣闭合术取得了极佳的美学和功能效果，随访期间瘢痕最小且未报告功能障碍。该病例突出了软骨样汗腺腺瘤相关的诊断和治疗挑战，尤其是在唇部等非典型部位。慢性光损伤的并存使临床情况更加复杂，强调了全面组织病理学评估的重要性。尽管该肿瘤罕见，但及时的手术干预和细致的伤口处理产生了良好的预后。本报告强调临床医生需要提高认识，以便早期诊断和适当管理罕见的皮肤肿瘤，并建议进行随访监测潜在复发情况。
