Malignant Chondroid Syringoma With Nose and Paranasal Sinus Extension: A Case Report

Abstract

Chondroid syringoma is a rare, skin appendageal tumor. It is also known as mixed tumor of skin, as it histologically resembles mixed tumor of salivary gland (pleomorphic adenoma). It is most commonly a benign tumor, but a few malignant counterparts have been described in history. It usually presents as a solid, slow-growing, solitary, and painless nodule in the head and neck region. Malignant counterpart is rare and commonly affects trunk and extremities. Early diagnosis and surgery by wide local excision are the most reliable treatments to date. Recurrences are common and hence close follow-up is advised. In this study, we present a case of malignant chondroid syringoma of face with extensive extension into nose and paranasal sinuses, which was recurrent and managed by surgical excision and radiotherapy. To the best of our knowledge, this is the first reported case with extension and bone destruction into nose and sinuses.

Keywords: chondroid syringoma; excision; malignant; nose and paranasal sinus; recurrence.

Figure 1.

Contrast-enhanced computed tomography of nose and paranasal sinuses. A, Coronal view showing a heterogeneously enhancing soft-tissue density causing destruction of the midline septum extending into the left nasal cavity, anterior and posterior ethmoid sinuses, and partially filling the left maxillary sinus with retained secretion. There is extension into the right nasal cavity, and there was no skull base or lamina papyracea erosion. B, Coronal view showing soft-tissue density anterior to nasal bone extending into nasal cavity and left maxillary sinus and ethmoid sinuses.

Figure 2.

A, External subcutaneous swelling (white arrow). B, Excised specimen.

Figure 3.

Histopathological picture (hematoxylin and eosin stain, 400× magnification) showing tumor cells arranged in the form of duct-like structure (black arrow) with chondromyxoid background.