Content area
Full Text
Eccrine syringofibroadenoma (ESFA) is a benign neoplasm arising from the intraepidermal portion of eccrine ducts. It is characterized by a distinctive histologic pattern of epithelial cells arranged in anastomosing cords surrounded by a fibrovascular stroma. Approximately 50 cases of ESFA have been reported, and in recent years the lesion has been described occurring in association with other skin conditions. We report 2 cases of ESFA arising in abdominal skin adjacent to enterostomy sites. Int J Surg Pathol 11 (1):61-63, 2003
Key words: eccrine, syringofibroadenoma, stomas, reactive, acrosyringium, ileostomy.
Originally described by Mascaro [1] in 1963, eccrine syringofibroadenoma (ESFA) is a benign neoplasm arising from the intraepidermal portion of eccrine ducts (acrosyringium). Though its clinical manifestations are quite variable, ESFA is characterized by a distinct histologic pattern of monomorphous epithelial cells arranged in anastomosing cords surrounded by a fibrovascular stroma. Eccrine duct lumina may be seen. To date, approximately 50 cases of ESFA have been reported [2]. In recent years the lesion has been described occurring in association with other skin conditions, including bullous pemphigoid, lichen planus, and diabetic foot ulcers [3-51. This has led to the recognition of a new subtype, reactive ESFA [6]. We report 2 cases of ESFA arising in abdominal skin adjacent to enterostomy sites.
Case Reports
Case 1
A 49-year-old white woman with a history of Gardner syndrome and insulin- dependent diabetes mellitus presented with a 3 x 1.4 cm pale, scaling, polypoid nodule at the inferior edge of her ileostomy. She had undergone a pancreaticoduodenectomy, hemigastrectomy, and proctocolectomy with end ileostomy for dysplastic gastrointestinal polyps. The stoma had been present for approximately 20 years. Recurrent nodules in the surrounding skin had been observed by her surgeon for approximately 5 years before this excision. A 3 x 1.4 x 1.4 cm elliptical excision of peristomal skin and subcutaneous tissue was submitted for histologic examination (see Results).
Case 2
A 76-year-old white man who had undergone colectomy for inflammatory bowel disease presented with a 4 x 2 cm firm, pale-gray cutaneous nodule adjacent to a long-standing colostomy site. The lesion had been previously excised and...