Syringocystadenoma Papilliferum

 Rare cases may transform to syringocystadenocarcinoma papilliferum

image Rarely, basal cell carcinoma may develop within SCP


• Endophytic/exophytic adnexal tumors
image Invaginations that communicate with epidermal surface

image Invaginations have papillary architecture

• Papillary structures lined by glandular epithelium with double layer
image Papillae communicate with duct-like structures in deeper aspects

image Basal layer is flattened to cuboidal

image Luminal layer usually columnar

• Characteristic stroma
image Fibrovascular connective tissue within papillae

image Numerous plasma cells admixed with some lymphocytes

Top Differential Diagnoses

• Hidradenoma papilliferum
image Lacks connection with epidermis

image Lacks plasma cells

• Tubular apocrine adenoma
image Lacks epidermal attachment

• SCP/malignant syringocystadenoma
image Architectural complexity

image Cytologic atypia

image Mitotic activity

Low-Power Image of Syringocystadenoma Papilliferum
Syringocystadenoma papilliferum has an endo/exophytic growth pattern with invaginations into the underlying dermis that have a papillary architecture image.

Syringocystadenoma Papilliferum With Transition From Squamous to Glandular Epithelium
The superficial aspects of the imaginations are lined by squamous epithelium image that transitions to glandular epithelium image.

Syringocystadenoma Papilliferum: High Magnification of Glandular Epithelium
The glandular component is composed of 2 cell layers with a basal myoepithelial layer image and a columnar glandular layer image.

High Magnification of Apocrine Glandular Epithelium and Plasma Cells
The glandular epithelium in this case shows evidence of apocrine differentiation image, with focal apical snouts and secretions. The stroma contains numerous plasma cells image.



• Syringocystadenoma papilliferum (SCP)


• Benign adnexal tumor with endophytic and exophytic growth pattern



• Subset of tumors show loss of heterozygosity for PTCH1 (PTCH) &/or CDKN2A (P16), suggesting role for loss of these tumor suppressor genes in some cases



• Age
image ~ 1/2 present at birth or childhood


• Scalp most common location, followed by face
• Solitary gray to dark brown papillomatous lesion

• Rarely multiple

• SCP seen in 5-19% of nevus sebaceus

image 2nd most common tumor arising in nevus sebaceus after trichoblastoma

• Rarely associated with other neoplasms (e.g., tricholemmoma, apocrine hidrocystoma)


• Surgical approaches
image Simple excision is curative


• Benign
image Rare cases may have associated basal cell carcinoma

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Apr 24, 2017 | Posted by in PATHOLOGY & LABORATORY MEDICINE | Comments Off on Syringocystadenoma Papilliferum

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