A verrucuous tumor of the leg
A 56-year-old woman, with no medical history, presented with a chronic
nodular lesion of the left leg, of two year’s duration. There were no
associated systemic symptoms. Physical examination revealed a warty mass
with a keratotic surface of measured 2 cm. (Figure 1)
A surgical excision was performed. Histological examination showed
hyperkeratosis, parakeratosis, papillomatosis and cystic invaginations
extending downwards from the epidermis. Two different epithelial cell
layers consisting of outer small cuboidal cells and inner columnar cells
were present. The papillary projections and dermis had also dense
infiltration of plasma cells. (Figure 2) Based on these findings, a
diagnosis of Syringocystadenoma Papilliferum (SCAP) of the leg was
established.
SCAP is a benign adnexal tumor. Most of the cases present with solitary
lesion in the head and neck region at birth or in early
childhood.1 In fact, only two cases of SCAP on lower
leg have been reported in literature.1,2 It is mainly,
associated with oragnoid nevus. Histogenesis of this tumor remains
controversial.2 Histopathologically, there is no
difference between SCAP on different locations.1Despite its rarity, we must consider it in the differential diagnosis of
any longstanding nodular lesion with crusted surface. Surgical excision
is curative.