A Case of Syringocystadenocarcinoma Papilliferum: Not Your Usual Suspect

Abstract

Syringocystadenocarcinoma papilliferum (SCACP) is an exceptionally rare cutaneous adnexal tumor that is infrequently encountered by clinicians worldwide. The tumor typically appears in the older population, affecting patients in their fifth and sixth decades of life without male or female predominance. Patients frequently present with a variable-sized hyperpigmented ulcerative lesion containing an exudate that has a long-standing course of progression from its benign counterpart, Syringocystadenoma papilliferum (SCAP). Additionally, the clinical presentation and morphology of the neoplasm can be easily confused with a variety of other skin cancers, such as squamous cell carcinoma (SCC), basal cell carcinoma (BCC), cutaneous lymphoma, and cutaneous metastasis. Therefore, histopathology and tissue analysis play an essential role in establishing an accurate diagnosis. However, the lesion is so rare that no definitive diagnostic markers have been established yet. We present a case of SCACP localized to the scalp of the patient. Our case study highlights the presence of specific tumor markers that could potentially serve as objective criteria for diagnosis.

Keywords: adnexal skin tumor; dermatology; nevus sebaceous; scalp lesion; skin histopathology; syringocystadenocarcinoma papilliferum; syringocystadenoma papilliferum.

Figure 1. Ulcerating SCACP lesion on the mid-frontal scalp.

Figure 2. Higher magnification shows papillary architecture and prominent nuclear atypia (H&E. X40).

Figure 3. The neoplastic aggregates (red circle) in the dermis with dense inflammatory cell infiltrate (H&E. X100).