Chondroid Syringoma of the Thenar Eminence in a US Veterans Administration (VA) Patient

Muntazim Mukit, MD; Ibrahim Ortanca, MD; Nina Krassilnik, MD; Kalyan Dadireddy, MD

Disclosures

ePlasty. 2021;21(ic4) 

In This Article

Description

A 56-year-old right-hand-dominant man with a history of hypertension presented with a left thenar eminence cystic mass that started 2 months earlier. The patient denied symptoms, trauma, drainage, or pain but was concerned as he had had a tumor removed from his left forearm previously. The mass was stable in size. On examination, the mass was 1.0 × 0.5 cm. The digits on the patient's left hand were neurovascularly intact; the patient had full range of motion and normal hand cascade. The differential included schwannoma versus ganglion cyst. The patient underwent operative excision and had an uneventful postoperative course. Pathology showed "acral skin with an encapsulated nodular tumor in the dermis, composed of a few ducts, some adipocytes and sheets of 'plasmacytoid' cytoplasm, focally residing in a myxoid stroma…. The appearances are consistent with a hyaline (myoepithelial) cell-rich mixed tumor or skin." The case report was deemed institutional board review exempt.

Figure 1.

Low-power image showing a well-circumscribed, encapsulated tumor in subcutis (H&E, original magnification × 2).

Figure 2.

Tumor is composed of epithelioid cells with abundant eosinophilic cytoplasm, representing myoepithelial cells. Scattered are a few ducts lined by cuboidal epithelial cells. The stroma is hyalinized (H&E, original magnification × 10).

Figure 3.

Broad-spectrum cytokeratin stains both epithelial and myoepithelial cells. Epithelial cells and staining ducts are more crisp (IHC for AE1/3, original magnification × 10).

Figure 4.

SMA immunohistostaining highlights the myoepithelial cells around ducts.

Figure 5.

Postoperative day 9 anteroposterior photograph of the left hand showing a well-healed incision of thenar eminence.

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