Journal of Postgraduate Medicine
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CASE REPORT
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Year : 1996  |  Volume : 42  |  Issue : 4  |  Page : 125-6  

Pleomorphic adenoma of skin (chondroid syringoma) involving the eyelid.

NN Tyagi, UU Abdi, SP Tyagi, VV Maheshwari, RR Gogi 
 Department of Pathology and Institute of Ophthalmology, Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh.

Correspondence Address:
N N Tyagi
Department of Pathology and Institute of Ophthalmology, Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh.

Abstract

Lid tumours are fairly common. However, pleomorphic adenoma (chondroid syringoma) is quite rare. In a series of 207 eyelid tumours and tumour like lesions, pleomorphic adenoma was observed in a male aged 41 years; its incidence being 0.48%.



How to cite this article:
Tyagi N N, Abdi U U, Tyagi S P, Maheshwari V V, Gogi R R. Pleomorphic adenoma of skin (chondroid syringoma) involving the eyelid. J Postgrad Med 1996;42:125-6


How to cite this URL:
Tyagi N N, Abdi U U, Tyagi S P, Maheshwari V V, Gogi R R. Pleomorphic adenoma of skin (chondroid syringoma) involving the eyelid. J Postgrad Med [serial online] 1996 [cited 2020 Dec 3 ];42:125-6
Available from: https://www.jpgmonline.com/text.asp?1996/42/4/125/439


Full Text




  ::   IntroductionTop


Pleomorphic adenoma or chondroid syringoma of the skin involving the eyelid is a rare tumour[1]. Occasional case reports have been published in Indian literature[2],[3]. This tumour can have either ecerine or apocrine differentiation. The authors have come across a single case of chondroid syringoma out of a series of 207 cases of tumours and tumour like conditions of the eyelid. The rarity of the lesion has promoted them to publish this case.


  ::   Case reportTop


M. A., a male aged 41 years presented with the complaint of nodular mass on the left upper eyelid for the last year. The growth was 5 mm in diameter, firm in consistency. The surface was smooth and there was no induration, ulceration or discharge. The mass was fixed to the underlying tarsus. There was no preauricular or submandibular lymphadenopathy. Clinically, the case was diagnosed as a case of Meibornian gland carcinoma of the left upper lid. The mass was excised and sent for histo-pathologic examination.

The mass removed was a small non-hairy nodule of 5 mm size with smooth surface and surrounded by a tag of the skin. Consistency was firm. There was no discharge. Cut surface was white and homogenous.

Morphologically the neoplasm was characterised by the presence of tubular glands of variable size, lying in a lightly bluish stained mucoid myxomatous stroma [Figure:1]. The mucoid stroma gave positive reaction with Alcian blue and stained metachromatically with toluidine blue. The glandular epithelial lining was double layered - the luminal layer was cuboidal and the outer spindle cell type or of vaueolated cells representing the myciepithelial component. Some of the tubular lumina contained small amount of amorphous eosinophilic diastase resistant material. In some areas, the tumour cells were spindle cell type suggesting a mesenchymal element probably derived from the myoepithelial cells. Mitoses as well as necrosis were not seen. A morphologic diagnosis of plemorphic adenoma or mixed tumour of the sweat gland involving the left upper lid was made.


  ::   DiscussionTop


Sweat gland tumours are usually solitary and almost invariably benign. They appear as hard circumscribed nodule in the skin, slowly growing and asymptomatic, but may assume a considerable size with polypoid term. They are frequently encapsulated[4]. Pleomorphic adenoma of the eyelid is still very rare as we have come across a single case out of a series of 207 cases of tumours and tumour like lesions of the eyelid, its incidence being 0.48%.

Hirsch and Helwig[5] introduced the term of chondroid syringoma in place of pleomorphic adenoma or mixed tumour of the skin, as the tumour is epithelial in nature (arising from the sweat gland elements) with secondary changes in the stroma (cartilage - like substance). These tumours usually occur as asymptomatic, firm well-circumscribed nodules of the size between 0.3 mm to 0.5 mm in diameter 5 as was also noticed in the present case.

Headington [6] has described 2 types of chondroid syringomas depending upon the morphological picture. The present case was chondroid syringoma with tubular, branching lumina. In general, the tubular structures are highly suggestive of eccrine differentiation[5]. The other variety is chondroid syringoma with small, tubular lumina in which glands are lined by single layer of flat epithelial cells. The tumour can differentiate either to eccrine or apocrine elements and very rarely it can undergo malignant change with widespread metastases[7].

References

1 Zimmerman LE, Sobin LK. Histological typing of tumour of eye and its adnexa. International Histological Classification of Tumour No.24. Geneva: World Health Organisation; 1980.
2Kapoor VK, Kumar S, Singh MK, Chattopadhyay TK. Pleomorphic adenoma of skin (Chondroid Syringoma). Indian J Pathol Microbiol 1986; 29:309-311.
3Vaishnav VP, Dharkar DD. Adnexal tumours of the skin. Indian J Pathol Bacteriol 1974; 17:33-38.
4Duke Elder S, Mac Faul PA. The ocular Adnexa. Diseases of the Eyelids. In Duke Elder's System of Ophthalmology Vol. 13, London: Henry Kimpton; 1974, pp 461-462.
5Hirsch P, Helwig EB. Chondroid Syringoma. Mixed tumour of the skin, salivary gland type. Arch Dermatol 1961; 84:835-847.
6Headington JI. Mixed tumours of the skin: Eccrine and apocrine types. Arch Dermatol 1961; 84:989-996.
7Shvili D, Rothem A. Fulminant metastasizing chondroid syringoma of the skin. Am J Dermatopathol 1986; 8:3215.

 
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