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Benign adnexalICD-10 D23

Chondroid syringoma (cutaneous mixed tumour)

Cutaneous mixed tumour; benign mixed tumour of skin

Chondroid syringoma is a benign adnexal tumour of skin showing biphasic differentiation — epithelial ductal structures within a chondromyxoid or hyalinised stroma — analogous to the pleomorphic adenoma of the salivary glands. It typically presents as a solitary, firm, slow-growing, skin-coloured nodule, 5–30 mm, on the head and neck of an adult. The diagnosis is almost always made histologically after excision because of clinical overlap with cysts, lipomas and BCC. A malignant counterpart (malignant chondroid syringoma) is rare but recognised, with metastatic potential; recurrence after incomplete excision of even benign lesions warrants careful pathology review.

CurrentLast reviewed 15 May 2026
Clinical image of Chondroid syringoma
Chondroid syringoma. Image sourced from DermNet New Zealand. Used under CC BY-NC-ND 4.0. No endorsement implied.

Clinical features

  • Solitary, firm, skin-coloured to pink nodule, 5–30 mm.
  • Distribution — head and neck (commonest), upper trunk, extremities, occasionally genitalia.
  • Slow growth over years; usually asymptomatic.
  • Median age 40–60; slight male predominance.
  • Long stability is typical of benign disease — rapid growth, ulceration or recurrence should raise concern for the malignant variant.

Histology

  • Biphasic — epithelial ducts and tubules within a chondroid, myxoid or hyalinised stroma.
  • Apocrine variant (predominantly head and neck) and eccrine variant (predominantly extremities) are described.
  • Immunohistochemistry — epithelial cells CK7+, EMA+, often gross-cystic-disease-fluid-protein 15 (GCDFP-15) positive in apocrine variant; myoepithelial cells S100+, SMA+, p63+.
  • Malignant chondroid syringoma — atypia, mitoses, infiltrative growth, necrosis; demands wide excision and staging.

Differential

  • Epidermoid cyst — central punctum, cheesy contents.
  • Lipoma — softer, mobile.
  • BCC — pearly, telangiectatic.
  • Pilomatrixoma — calcified, paediatric/adolescent.
  • Apocrine adenoma; eccrine spiradenoma — overlap on biopsy.
  • Salivary pleomorphic adenoma (parotid or accessory salivary tissue) — consider for periauricular lesions.

Management

  • Complete surgical excision with histology — diagnostic and definitive for benign disease.
  • Confirmed benign disease — reassurance, no further treatment.
  • Malignant chondroid syringoma — wide local excision with margins per pathology, MDT discussion, baseline imaging (CT NCAP), surveillance.
  • Recurrence after incomplete excision can occur even with benign histology — request careful re-review of margins.

References

  1. Hirsch P, Helwig EB. Chondroid syringoma — mixed tumor of skin, salivary gland type. Arch Dermatol; 1961.
  2. Mentzel T et al. Malignant chondroid syringoma — a clinicopathologic study. Histopathology; 2003.
  3. WHO Classification of Tumours Editorial Board. Skin Tumours, WHO Classification of Tumours, 5th ed., vol. 12. Lyon: IARC; 2025.

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