An Uncommon Tumour with a Classic Face: Syringocystadenoma Papilliferum

A 55-year-old female came with an asymptomatic reddish growth on the scalp for the past 2 years, over a slightly elevated flat hairless area on the scalp, which she claimed had been present since birth. There was no history of any trauma at the site or any bleeding from the lesion. On examination, there was a solitary reddish verrucous surfaced plaque over a thin flat hairless skin coloured to hyperpigmented plaque on the scalp. The lesion was soft to firm and non-tender. Lymph nodes were not enlarged and systemic examination was unremarkable. Clinical differential diagnoses included squamous cell carcinoma, pyogenic granuloma, warts, cutaneous metastasis and adnexal neoplasm over a nevus sebaceous [Figure 1]. Biopsy of reddish lesion showed multiple papillary projections and cystic invaginations lined by an epithelium which possessed apocrine differentiation. Lining epithelium had two rows of cuboidal to columnar cells showing decapitation secretion. Few ductal structures were seen. Stroma showed a dense infiltrate of mononuclear cells predominantly comprising plasma cells. A final diagnosis of syringocystadenoma papilliferum over a nevus sebaceous was rendered [Figures 2 and 3].

Close

Figure 1:

Solitary reddish verrucous surface plaque over a thin, flat hairless skin-coloured plaque over the scalp.

Export to PPT

Close

Figure 2:

Architecture of tumour showing cystic invaginations (black arrow) and papillary projections (blue arrow) [Haematoxylin and Eosin x40].

Export to PPT

Close

Figure 3:

Double layered lining epithelium showing apocrine differentiation (Black circle) and plasma cell infiltrate in stroma (White arrow) [Haematoxylin and Eosin x400].

Export to PPT