Eccrine Syringofibroadenoma: Report of a Case and Analysis of Cytokeratin Expression

Abstract

Eccrine syringofibroadenoma (ESFA) is a rare disorder which shows differentiation toward the eccrine sweat apparatus. There is a controversy concerning the pathogenesis and precise differentiation of this tumor. We report a case of ESFA and its differentiation pattern by an analysis of cytokeratin expression. Using paraffin-embedded materials, histopathological and immunohistochemical studies were performed. Staining patterns of the luminal, peripheral, and inner cells of the tumor strands closely matched or mimicked those of the luminal, outer and intermediate cells of the normal eccrine dermal duct, respectively. The case of ESFA reported revealed a pattern of differentiation suggestive of an eccrine duct origin.

Eccrine Syringofibroadenoma in a Patient with Long-Standing Exfoliative Dermatitis

“…In addition, the increased mast cells observed in several of these cases1011 are a characteristic feature of healing wounds and also suggest that ESFA may be a response of the eccrine duct to ongoing tissue remodeling. The histological presentation of ESFA is unique, and the ultrastructural and immunohistochemical features reported in the literature support acrosyringeal11 or intradermal eccrine duct differentiation1213. However, because of the clinical polymorphism, it is still unclear whether ESFA is a neoplasm, hamartoma, or reactive eccrine hyperplasia.…”

Reactive eccrine syringofibroadenoma arising in peristomal skin: An unusual presentation of a rare lesion

“…* The consensus belief is that ESFA derives from or differentiates toward the acrosyringium or eccrine dermal duct. [8][9][10][11][12][13][14] It is still unclear whether the lesion is neoplastic, hamartomatous, or reactive in nature. 5,21,[24][25][26][27] ESFA typically presents in older adults with a predilection for the extremities.…”

“…22,28 Immunohistochemical studies show that the lesional cells are positive for keratin 6, keratin 19, and filaggrin. [9][10][11][12]14,23 In addition, electron microscopic studies show that the ducts have a keratinization pattern similar to acrosyringeal cells. 9,13 ESFA has been associated with numerous entities/conditions, which are summarized in Table I.…”

“…3,7 ESFA is believed to derive from or differentiate toward the acrosyringium or eccrine dermal duct. [8][9][10][11][12][13][14] The clinical course of ESFA is typically benign. 2,3 However, recent reports suggest the possibility of an association of ESFA with squamous cell carcinoma or malignant transformation of ESFA.…”

A Case of Subungual Reactive Eccrine Syringofibroadenoma

“…There is a controversy concerning the histogenesis and the precise differentiation of this tumor. Based on cytokeratin expression, some reports suggested acrosyringeal differentiation [3, 4], others suggested differentiation towards the eccrine dermal duct [5, 6, 7]and some results even suggested dual acrosyringeal and dermal duct differentiation [8]. ESFA is a characteristic histologic entity (reticulate proliferation of epithelial cells with eccrine duct lumina in fibrovascular stroma) with a polymorphous clinical presentation: either papules, nodules or plaques, solitary or multiple.…”