Cutaneous Mixed Tumor (Chondroid Syringoma)

Chondroid Syringoma/Cutaneous Mixed Tumor Low Magnification
Low magnification shows a well-circumscribed tumor composed of epithelial islands image with easily identifiable glandular/ductal structures image embedded in a myxoid and hyaline image stroma.

Cutaneous Mixed Tumor With Ductal Lumina and Myxoid Stroma
Small ducts image lined by cuboidal cells are a common finding. The classic abundant myxoid and cartilaginous stroma is also seen image.

Cutaneous Mixed Tumor at High Magnification
Ductal structures image with some foci of decapitation secretion image are present in the epithelial component.

Cutaneous Mixed Tumor Composed of Basaloid Cells
This chondroid syringoma is composed mostly of small, cuboidal-shaped basaloid cells surrounding multiple ductal lumina image.



• Cutaneous mixed tumor (CMT)


• Apocrine mixed tumor

• Eccrine mixed tumor

• Mixed tumor of folliculosebaceous-apocrine complex


• Well-circumscribed benign epithelial tumor with chondromyxoid matrix



• Incidence
image Rare

• Age
image Middle-aged to elderly

• Sex
image Male predominance

• Ethnicity
image No ethnic predilection


• Head and neck sites are most common

• Extremities and trunk


• Skin-colored, asymptomatic, dermal to subcutaneous tumors

Natural History

• Slow growth


• Surgical excision


• Excellent
image Very rare malignant transformation



• 0.5-3.0 cm

Sections to Be Submitted

• Representative sections of grossly different-appearing areas should be submitted


Histologic Features

• Well-circumscribed dermal to subcutaneous tumor
• Composed of proliferation of epithelial cells embedded in myxoid, chondroid, or fibrous stroma

• Apocrine ducts within tumor can be seen

image Many authors consider CMT to be predominately tumor of apocrine origin

• Differentiation toward different parts of folliculosebaceous-apocrine complex reported
image Focal areas of matrical or sebaceous differentiation may rarely be seen

• Eccrine differentiation may be present in some cases

• Large amounts of adipose tissue are seen in what are called lipomatous mixed tumors

• Calcification and ossification are rare focal findings

• Due to shrinkage of stroma, fibroblasts and epithelial cells within stroma are surrounded by halos and appear similar to cells of cartilage

• Epithelial component
image Epithelial cells can be arranged singly, in small and large clusters, or in solid cords

image Ductal structures are of variable size and shape

image CMTs have been divided into 2 types according to ductal structures by some
– Tumors with tubular, branching lumina

– Tumors with small, tubular lumina

image Cystic dilation and branching of ducts is common

image PAS(+), amorphous, eosinophilic material (collagenous spherulosis) can be seen in tubular lumina

image Larger ducts lined by 2 layers of cuboidal cells and peripheral layer of myoepithelial cells

image Some CMT composed predominantly of small ducts and small epithelial clusters

image Small ducts lined by single layer of cuboidal cells

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Apr 24, 2017 | Posted by in PATHOLOGY & LABORATORY MEDICINE | Comments Off on Cutaneous Mixed Tumor (Chondroid Syringoma)

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