Eccrine Cylindroma of Lip Lt Col Sanjay Kumar Chakraborty., Col SK Nema + MJAFI2002; 58: 346-347 Key Words: Eccrine cylindroma; Sebacrous glands; Sweat gland tumour
Introduction
T
he sweat gland s are coiled glands of two varieties, eccrine and apocrine. While eccrine tumours of the skin are common, eccrine tumours extending into the oral cavity are very rare. This is the first case of eccrine cylindroma extending into the oral cavity to be reported in literature. EI Mofty et al [I] have reported a case of intraosseous tubulopapillary hidradenoma of the mandible in 1998. Clinically one experiences a great deal of difficulty in diagnosing these tumours. Case Report A 65 year old male patient reported with slowly enlarging, painless swelling of the upper lip for the past one year. The patient had been operated upon 10 years back and the diagnosis recorded was 'soft tissue tumour' . Previous medical documents or histopathological reports were not available. A round swelling was visible on the philtrum of the upper lip (Fig I). 6 nontender nodules. each measuring I x 1.5 em extending from the vermilion border to the rnucogingival junction. could be palpated submucosally. Overlying mucous membrane was intact. The skin on the lip was non ulcerated. There was no regional lymphadenopathy . There was no bone involvement. The patient was taken up for operation under general anaesthesia. An intra oral incision was given on upper lip midway between the mucolabial fold and 'wet line' of the lip. After submucous dissection. six nodules were enucleated. Haemostasis was achieved and the wound was sutured. Two nodules when
cut with a scalpel, revealed soft, white, solid mass. The specimen was sent for histopathological examination. Microscopic examination showed encapsulated nodules with monomorphic cells arranged in cords and tubules with acinar arrangement at places. These cells had deeply basophilic nuclei with eosinophilic cytoplasm. In the back ground hyaline material was seen . Few of the acini had secretions in them . No features of malignancy were seen. A diagnosis of eccrine cylindroma was made (Fig-Z),
Discussion The presence of oral sebaceous glands usually involving the verm ilion of the upper lip and the buccal mucosa is a common situation in most of the population (2,3] but there is no reported incidence of occurrence of sweat gland tumour in the oral cavity. Benign tumours of the sweat apparatus are either ductal (syringa\) in origin or may arise from deeper glandular portion or may be apocrine in nature [4]. Syringomas are benign tumours of eccrine origin. most commonly found in the periorbital area [5). Malignant clear cell hidradenoma is an uncommon tumour of eccrine sweat gland origin that has a predilection for head and neck [6]. Sclerosing sweat duct carcinoma (SSDC) is a rare slow growing locally invasive skin tumour of eccrine and pilar origin. It is usually located on the face. particularly upper lip, cheek and forehead. It has been infrequently reported on the eyelid. secondarily involved from adjacent cheek and eyebrow tumours (7). Oral mucosa does not contain any type of sweat gland.
Fig . :!: Fig. I : Eccrine cylindroma Ill' the orul c uvit y
Eccrine cyl indroma : photomicrograph showing monomorphic cell, in cords, tubule" and acini
;Cl ;a, ,,ificd S pcc iulivt (O ral and Ma xillofaci nl Surgery}. Mil iturv Dental C entre, Premnagur. Dchrudun . :!4K 007 (Pathology I. Army Hnspifu] (R& R l. Delhi ('anll - I 10 0 I(I,
' Senio r Advisor
Eccrine Cylindroma
In this patient, the origin of the tumour in all likelihood, was from the adnexae of the skin covering the upper lip with a gross extension palpable submucosally from the oral aspect. Post operatively the upper lip returned to its normal thickness. The patient was followed up for one year. There was no evidence of recurrence. References I. EI Mofty SK, Hurt MA, Santacruz DJ. Tubulopapillary hidradenoma like tumour of the mandible. Oral Surg Oral Med Oral Pathol 1998;85:431-7. 2. Daley T. Pathology of intra oral sebaceous glands. 1 Oral Pathol Med 1993;22:241-3.
347 3. Jun Li T, Kitano M, Mukai H, Yamashita S. a.. .d sebaceous carcinoma : report of a case. 1 Oral Maxillofac Surg 1997;54:751-4. 4. Allen AC. Skin. In : Kissane 1M, editor. Anderson's Pathology Vol 2, 9 lh ed, CV Mosby. St Louis 1990; 1830-5. 5. Wang JI, Roenigk HH Jr. Treatment of multiple facial syringomas with the carbondioxide laser. Dennatol Surg 1999;25(2), 136-9.
6. Orlandi RR, Seccarz lA. Dobemeck SA, Calcaterra TC. Malignant clear cell hidradenoma of the upper lip. Head neck 1994;16(5):443-9.
7. Duffy MT. Harrison W, Sassoon 1, Homblass A. Sclerosing sweat duct carcinoma of the eyelid margin : unusual presentation of a rare tumour, Ophthalmology 1999;106(4):751-6.
Introduction
T
he sweat gland s are coiled glands of two varieties, eccrine and apocrine. While eccrine tumours of the skin are common, eccrine tumours extending into the oral cavity are very rare. This is the first case of eccrine cylindroma extending into the oral cavity to be reported in literature. EI Mofty et al [I] have reported a case of intraosseous tubulopapillary hidradenoma of the mandible in 1998. Clinically one experiences a great deal of difficulty in diagnosing these tumours. Case Report A 65 year old male patient reported with slowly enlarging, painless swelling of the upper lip for the past one year. The patient had been operated upon 10 years back and the diagnosis recorded was 'soft tissue tumour' . Previous medical documents or histopathological reports were not available. A round swelling was visible on the philtrum of the upper lip (Fig I). 6 nontender nodules. each measuring I x 1.5 em extending from the vermilion border to the rnucogingival junction. could be palpated submucosally. Overlying mucous membrane was intact. The skin on the lip was non ulcerated. There was no regional lymphadenopathy . There was no bone involvement. The patient was taken up for operation under general anaesthesia. An intra oral incision was given on upper lip midway between the mucolabial fold and 'wet line' of the lip. After submucous dissection. six nodules were enucleated. Haemostasis was achieved and the wound was sutured. Two nodules when
cut with a scalpel, revealed soft, white, solid mass. The specimen was sent for histopathological examination. Microscopic examination showed encapsulated nodules with monomorphic cells arranged in cords and tubules with acinar arrangement at places. These cells had deeply basophilic nuclei with eosinophilic cytoplasm. In the back ground hyaline material was seen . Few of the acini had secretions in them . No features of malignancy were seen. A diagnosis of eccrine cylindroma was made (Fig-Z),
Discussion The presence of oral sebaceous glands usually involving the verm ilion of the upper lip and the buccal mucosa is a common situation in most of the population (2,3] but there is no reported incidence of occurrence of sweat gland tumour in the oral cavity. Benign tumours of the sweat apparatus are either ductal (syringa\) in origin or may arise from deeper glandular portion or may be apocrine in nature [4]. Syringomas are benign tumours of eccrine origin. most commonly found in the periorbital area [5). Malignant clear cell hidradenoma is an uncommon tumour of eccrine sweat gland origin that has a predilection for head and neck [6]. Sclerosing sweat duct carcinoma (SSDC) is a rare slow growing locally invasive skin tumour of eccrine and pilar origin. It is usually located on the face. particularly upper lip, cheek and forehead. It has been infrequently reported on the eyelid. secondarily involved from adjacent cheek and eyebrow tumours (7). Oral mucosa does not contain any type of sweat gland.
Fig . :!: Fig. I : Eccrine cylindroma Ill' the orul c uvit y
Eccrine cyl indroma : photomicrograph showing monomorphic cell, in cords, tubule" and acini
;Cl ;a, ,,ificd S pcc iulivt (O ral and Ma xillofaci nl Surgery}. Mil iturv Dental C entre, Premnagur. Dchrudun . :!4K 007 (Pathology I. Army Hnspifu] (R& R l. Delhi ('anll - I 10 0 I(I,
' Senio r Advisor
Eccrine Cylindroma
In this patient, the origin of the tumour in all likelihood, was from the adnexae of the skin covering the upper lip with a gross extension palpable submucosally from the oral aspect. Post operatively the upper lip returned to its normal thickness. The patient was followed up for one year. There was no evidence of recurrence. References I. EI Mofty SK, Hurt MA, Santacruz DJ. Tubulopapillary hidradenoma like tumour of the mandible. Oral Surg Oral Med Oral Pathol 1998;85:431-7. 2. Daley T. Pathology of intra oral sebaceous glands. 1 Oral Pathol Med 1993;22:241-3.
347 3. Jun Li T, Kitano M, Mukai H, Yamashita S. a.. .d sebaceous carcinoma : report of a case. 1 Oral Maxillofac Surg 1997;54:751-4. 4. Allen AC. Skin. In : Kissane 1M, editor. Anderson's Pathology Vol 2, 9 lh ed, CV Mosby. St Louis 1990; 1830-5. 5. Wang JI, Roenigk HH Jr. Treatment of multiple facial syringomas with the carbondioxide laser. Dennatol Surg 1999;25(2), 136-9.
6. Orlandi RR, Seccarz lA. Dobemeck SA, Calcaterra TC. Malignant clear cell hidradenoma of the upper lip. Head neck 1994;16(5):443-9.
7. Duffy MT. Harrison W, Sassoon 1, Homblass A. Sclerosing sweat duct carcinoma of the eyelid margin : unusual presentation of a rare tumour, Ophthalmology 1999;106(4):751-6.
