Syringocystadenocarcinoma papilliferum: a case report

Abstract

Syringocystadenocarcinoma papilliferum (SCACP) is a rare form of adenocarcinoma of the skin. This is the malignant counterpart of syringocystadenoma papilliferum (SCAP) and usually develops on the scalp in a long-standing lesion identified clinically as SCAP. We describe a 65-yr-old Korean man with a nodule on the right supra-pubic area with a 2-yr duration. Histologically this tumor had a similar overall configuration as in SCAP, but the tumor was asymmetric and poorly circumscribed, extending into the deep dermis and showed cytologic atypia. The tumor cells showed positive reaction to GCDFP-15, but negative reaction to CEA and HMFG-1. We established the diagnosis of SCACP in the patient, and a wide excision was performed to remove the tumor. The patient has been well without relapse or metastasis for 2 yr.

Fig. 1

A single 3.4×3.5 cm-sized erythematous dome-shaped nodule covered with bloody crust on the right suprapubic area.

Fig. 2

A low-power view of the lesion shows a tumor with a solid and cystic pattern in the upper dermis and diffusely infiltrating the lower dermis (H&E, ×1).

Fig. 3

Tumor cells of strand or cord structures in the deep reticular dermis with desmoplastic stroma (H&E, ×40).

Fig. 4

(A) Cystic invagination connected to the infundibular portion extends downward (H&E, ×40). (B) Inferior portion of cystic invagination lined by multiple layered epithelium with decapitation on the luminal surface of the cells, numerous plasma cells and lymphocytes in the stroma (H&E, ×100).

Fig. 5

(A) Tumor cells having large and hyperchromatic nuclei (H&E, ×200). (B) Hyperchromatic nuclei and mitotic figures were observed in these tumor cells (H&E, ×200).