A rare large cutaneous chondroid syringoma involving a toe: A case report

Abstract

Rationale: Chondroid syringoma (CS) occurs mostly on the face and neck, and rarely occurs in the toe. Malignant CS is invasive, grows quickly, and has a high recurrence rate. The presence of a bilobed CS in 1 toe has never been reported in the literature.

Patient concerns: A 72-year-old male patient presented with a mass in a third toe of his right foot. The mass had slowly grown in 2 years. He felt mild pain and the mass occupied most of the tip of the toe.

Diagnoses: Radiographs showed a large soft-tissue mass in the third toe of his right foot without any bone destruction. Ultrasonogram showed 2 partly fused hypoechoic masses within the lesion. The mass was therefore diagnosed as a benign CS.

Interventions: We amputated the toe with the mass under local anesthesia. The postoperative pathohistological examinations confirmed that the lesion was a bipartite CS exhibiting active cellular proliferation.

Outcomes: Two years after surgery, there was no tumor recurrence.

Lessons: CS can also present as multiple adjacent masses. Complete surgical resection and long-term follow-up are essential.

Figure 1

Preoperative photograph showing a large tumor in the third toe of the right foot.

Figure 2

Radiograph showing a large soft-tissue mass in the third toe of the right foot without any bone destruction.

Figure 3

Preoperative ultrasonogram of the lesion in the toe. (A) The 2 partly fused hypoechoic masses measuring 1.3 × 1.3 cm and 1.2 × 1.6 cm. (B) Sonolucent fluid was seen in the lesion, and the lesion was well vascularized.

Figure 4

Intraoperative photograph shows that the lesion is composed of 2 masses, and together was 2.3 × 1.5 × 1.2 cm. The lesion has no capsule.

Figure 5

Pathological examination of tumor using hematoxylin–eosin staining. A. Tumor cells are arranged in nodular structures with glass-like changes and glandular tube structures in the intercellular matrix (original magnification 100×). (B) Focal myxoid in the chondroid intercellular matrix (original magnification 100×). (C) Tumor cells vary in size and exhibit significant nuclear atypia and frequent mitoses (original magnification 400×).

Figure 6

Immunohistochemical analysis of tumor showing that tumor cells are S-100-positive cells (A) and pan-cytokeratin-positive cells (B) (original magnification 100×).