Mixed tumour of the skin of the lower lip: A case report and review of the literature

Gotoh,Shimpei; Ntege,Edward H.; Nakasone,Toshiyuki; Matayoshi,Akira; Miyamoto,Sho; Shimizu,Yusuke; Nakamura,Hiroyuki

doi:10.3892/mco.2022.2502

Mixed tumour of the skin of the lower lip: A case report and review of the literature

Authors:
- Shimpei Gotoh
- Edward H. Ntege
- Toshiyuki Nakasone
- Akira Matayoshi
- Sho Miyamoto
- Yusuke Shimizu
- Hiroyuki Nakamura
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Affiliations: Department of Oral and Maxillofacial Surgery, Graduate School of Medicine, University of the Ryukyus, Nishihara, Okinawa 903‑0215, Japan, Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, University of the Ryukyus, Nishihara, Okinawa 903‑0215, Japan
Published online on: January 24, 2022 https://doi.org/10.3892/mco.2022.2502
Article Number: 69
Copyright: © Gotoh et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

Mixed tumour of the skin or chondroid syringoma (CS) is a rare and mostly benign neoplasm of the sweat glands. Although CS is frequently located on varied parts of the head and neck region, the lower lip is a rarely reported site. The present report describes a case of CS of the lower lip in a 58‑year‑old male as an expository case to further emphasise the need for proper diagnosis, appropriate treatment and prognostic evaluation. The patient presented with a round, non‑tender, slightly hard and mobile mass beneath the mucocutaneous junction of his left lateral side of the lower lip. Radiology revealed a mass measuring 11x11x7 mm3 in size at a depth of ~2 mm. Furthermore, magnetic resonance T1‑ and T2‑weighted images showed slightly low and high signal intensities, respectively. A provisional diagnosis of benign tumour of the lower lip was made, and surgical excision biopsy taken under local anaesthesia, while considering the patient's cosmetic appearance. Histopathology demonstrated features akin to apocrine gland, chondroid and myxoid stroma consistent with the diagnosis of benign CS. No evidence of recurrence or satellites were recorded after a follow‑up of nearly 2 years. Although rare, a high index of suspicion for CS among other cutaneous adnexal tumours of the lower lip is necessary. In addition, interprofessional collaboration in the management of such oral tumours could enhance patient satisfaction amid prevailing intraoral and aesthetic concerns.

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1	Sulochana S, Manoharan M and Anith : Chondroid syringoma-an unusual presentation. J Clin Diagn Res. 8:FD13–FD14. 2014.PubMed/NCBI View Article : Google Scholar
2	Billroth T: Observations on the tumors of salivary glands. Archiv Pathol Anat Physiol Clin Med. 17:357–375. 1859.
3	Gianotti R, Coggi A and Alessi E: Cutaneous apocrine mixed tumor: Derived from the apocrine duct of the folliculo-sebaceous-apocrine unit? Am J Dermatopathol. 20:53–55. 1998.PubMed/NCBI View Article : Google Scholar
4	Hirsch P and Helwig EB: Chondroid syringoma. Mixed tumor of skin, salivary gland type. Arch Dermatol. 84:835–847. 1961.PubMed/NCBI View Article : Google Scholar
5	Bergeron S, Ito H, Arthurs B and Burnier MN Jr: Pleomorphic adenoma of the eyelid skin: A series of three atypical cases. Human pathology: Case Reports. 20(200384)2020.
6	Headington JT: Mixed tumors of skin: Eccrine and apocrine types. Arch Dermatol. 84:989–996. 1961.PubMed/NCBI View Article : Google Scholar
7	Hassab-el-Naby HM, Tam S, White WL and Ackerman AB: Mixed tumors of the skin. A histological and immunohistochemical study. Am J Dermatopathol. 11:413–428. 1989.PubMed/NCBI View Article : Google Scholar
8	Rodrigues BTG, Romañach MJ, de Andrade BAB, de Almeida Freire N and Israel MS: Chondroid syringoma of the lower lip: Case report. J Oral Maxillofac Surg Med Pathol. 33:486–488. 2021.
9	Bekerecioglu M, Tercan M, Karakok M and Atik B: Benign chondroid syringoma: a confusing clinical diagnosis. Eur J Plast Surg. 25:316–318. 2002.
10	Stout AP and Gorman JG: Mixed tumors of the skin of the salivary gland type. Cancer. 12:537–543. 1959.PubMed/NCBI View Article : Google Scholar
11	Shilpa K, Leelavathy B, Divya G and Lakshmi D: Chondroid syringoma: Histopathology a cornerstone tool in diagnosis. Indian J Dermatopathol Diagn Dermatol. 3(20)2016.
12	Triantafyllou AG and Rapidis AD: Chondroid syringoma of the upper lip: Report of a case. J Oral Maxillofac Surg. 44:744–748. 1986.PubMed/NCBI View Article : Google Scholar
13	Reddy PB, Nandini DB, Sreedevi R and Deepak BS: Benign chondroid syringoma affecting the upper lip: Report of a rare case and review of literature. J Oral Maxillofac Pathol. 22:401–405. 2018.PubMed/NCBI View Article : Google Scholar
14	Adlam DM and Wood GA: The chondroid syringoma (mixed tumor of skin). Report of a case in the upper lip. Oral Surg Oral Med Oral Pathol. 61:69–72. 1986.PubMed/NCBI View Article : Google Scholar
15	Arikan OK, Erdoğan S, Muluk NB and Koç C: Chondroid syringoma of the upper lip: A case report. Kulak Burun Bogaz Ihtis Derg. 13:25–27. 2004.PubMed/NCBI
16	Shimizu M, Kawano K, Fujiwara S, Noguchi T and Goto Y: Mixed tumor of the skin (chondroid syringoma) occurring in the upper lip: Report of a case. J Jpn Soc Oral Oncol. 15:37–41. 2003.(In Japanese).
17	Dubb M and Michelow P: Cytologic features of chondroid syringoma in fine needle aspiration biopsies: A report of 3 cases. Acta Cytol. 54:183–186. 2010.PubMed/NCBI View Article : Google Scholar
18	Girgis S, Gillan G and Piper K: Rare benign mixed tumour of the upper lip: A case report. Ann Med Surg (Lond). 4:380–383. 2015.PubMed/NCBI View Article : Google Scholar
19	Kundu R, Punia RS, Handa U and Dalal U: Chondroid syringoma: Cytomorphology of four cases and review of literature. Arch Cytol Histopathol Res. 1:63–67. 2016.
20	Min KH, Byun JH, Lim JS, Lee HK, Lee WM and Joo JE: Chondroid syringoma on face. Arch Craniofac Surg. 17:173–175. 2016.PubMed/NCBI View Article : Google Scholar
21	Vázquez Hernández A, Pérez Campos AE, Gamboa Jiménez TI and Fenton Navarro BF: Giant chondroid syringoma on the upper lip: A case report. Dermatol Online J: May 15, 2021 (Epub ahead of print). doi: 10.5070/D327553622, 2021.
22	Syed MA, Paudel U, Rajbhandari A, Pokhrel DB, Adhikari RC and Parajuli S: Fine needle aspiration cytology as a preliminary diagnostic tool in chondroid syringoma: A case report and review. Clin Cosmet Invest Dermatol. 12:209–218. 2019.PubMed/NCBI View Article : Google Scholar
23	Palit A, Sethy M, Nayak AK, Ayyanar P and Behera B: Dermoscopic features in a case of chondroid syringoma. Indian J Dermatol Venereol Leprol. 87:89–92. 2021.PubMed/NCBI View Article : Google Scholar
24	Zumdick M, Milde P, Ruzicka T and Hölzle E: Apokriner kutaner Mischtumor mit follikulärer Differenzierung. Der Hautarzt. 46:481–484. 1995.PubMed/NCBI View Article : Google Scholar
25	Shimizu S, Han-Yaku H, Fukushima S and Shimizu H: Immunohistochemical study of mixed tumor of the skin with marked ossification. Dermatology. 193:255–257. 1996.PubMed/NCBI View Article : Google Scholar
26	Satter EK and Graham BS: Chondroid syringoma. Cutis. 71:49–55. 2003.PubMed/NCBI
27	Wan H, Xu M and Xia T: Clinical and pathological study on mixed tumors of the skin. Medicine (Baltimore). 97(e12216)2018.PubMed/NCBI View Article : Google Scholar
28	Greeley PW, Gleason MC and Curtin JW: Mixed cell tumors of the skin. Plast Reconstr Surg (1946). 18:427–435. 1956.PubMed/NCBI View Article : Google Scholar
29	Chęciński M, Sikora M, Sielski M and Chlubek D: Pleomorphic adenoma of the lip-a case report. Pomeranian J Life Sci. 67:27–32. 2021.
30	Matsuyama A, Hisaoka M and Hashimoto H: PLAG1 expression in cutaneous mixed tumors: An immunohistochemical and molecular genetic study. Virchows Arch. 459:539–545. 2011.PubMed/NCBI View Article : Google Scholar
31	Russell-Goldman E, Dubuc A and Hanna J: Differential expression of PLAG1 in apocrine and eccrine cutaneous mixed tumors: Evidence for distinct molecular pathogenesis. Am J Dermatopathol. 42:251–257. 2020.PubMed/NCBI View Article : Google Scholar
32	Nakayama H, Miyazaki E, Hiroi M, Kiyoku H, Naruse K and Enzan H: So‐called neoplastic myoepithelial cells in chondroid syringomas/mixed tumors of the skin: Their subtypes and immunohistochemical analysis. Pathol Int. 48:245–253. 1998.PubMed/NCBI View Article : Google Scholar
33	Paik YS and Liess BD: Chondroid syringoma of the scalp: Case report and discussion of clinical features, histopathology, and treatment. Ear Nose Throat J. 90:190–191. 2011.PubMed/NCBI View Article : Google Scholar
34	Saga K: Histochemical and immunohistochemical markers for human eccrine and apocrine sweat glands: An aid for histopathologic differentiation of sweat gland tumors. J Investig Dermatol Symp Proc. 6:49–53. 2001.PubMed/NCBI View Article : Google Scholar
35	Kakuta M, Tsuboi R, Yamazaki M, Sakuma M, Yoshikata R and Ogawa H: Giant mixed tumor of the face. J Dermatol. 23:369–371. 1996.PubMed/NCBI View Article : Google Scholar
36	Kerimoglu U, Aydingoz U, Ozkaya O, Aksu AE and Ergen FB: MRI of a benign chondroid syringoma. Br J Radiol. 79:e59–e61. 2006.PubMed/NCBI View Article : Google Scholar
37	Kunikane H, Ishikura H, Yamaguchi J, Yoshiki T, Itoh T and Aizawa M: Chondroid syringoma (mixed tumor of the skin). A clinicopathological study of 13 cases. Acta Pathol Jpn. 37:615–625. 1987.PubMed/NCBI View Article : Google Scholar
38	Ishimura E, Iwamoto H, Kobashi Y, Yamabe H and Ichijima K: Malignant chondroid syringoma. Report of a case with widespread metastasis and review of pertinent literature. Cancer. 52:1966–1973. 1983.PubMed/NCBI View Article : Google Scholar
39	Sharvill DE: Mixed salivary-type tumour of the skin with malignant recurrence. Br J Dermatol. 74:103–104. 1962.PubMed/NCBI
40	Redono C, Rocamora A, Villoria F and Garcia M: Malignant mixed tumor of the skin: Malignant chondroid syringoma. Cancer. 49:1690–1696. 1982.PubMed/NCBI View Article : Google Scholar
41	Gardner JM and Smoller BR: Malignant mixed tumor of skin. In: Rare Malignant Skin Tumors. Springer, New York, NY, pp77-80, 2015.