CME

Continuing Medical Education

Syringomatous Carcinoma in a Young Patient Treated With Mohs Micrographic Surgery

Hu JC, Ko CJ, Soriano TT, Chiu MW

Cutis. 2006;77:19-24.

Syringomatous carcinoma (SC) has typically been observed in middle-aged and older patients. We report a case of SC mimicking an epidermoid cyst in a 23-year-old Asian man. Histopathologic examination results showed a dermal neoplasm consisting of nests of basaloid cells, focal areas of ductal differentiation, moderate dermal fibrosis, and moderate nuclear atypia consistent with a diagnosis of SC. No perineural involvement was noted. Results of immunohistochemical analysis revealed positivity for high– and low–molecular-weight cytokeratins, as well as for carcinoembryonic antigen (CEA). There was scattered immunoreactivity to S-100 protein. The tumor was completely excised using Mohs micrographic surgery (MMS). This case demonstrates the importance of differentiating SC from other benign or malignant entities, the value of a prompt diagnosis of SC, and the effective treatment of SC with MMS.

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