Malignant Transformation of Solitary Cylindroma Involving the Frontonasal Region- A Rarity

Abstract

Cylindromas are adnexal tumours of either eccrine or apocrine origin. Two common variants- Solitary and Multiple are seen, of which the malignant transformation of a solitary lesion is rare. Solitary tumours occur sporadically in the head and neck and are without a familial history whereas the multiple tumours are inherited in an autosomal dominant pattern occurring in scalp and rarely on trunk. Malignant transformation is observed commonly in multiple tumours, although transformation of solitary lesions has also been reported. We report a rare case of malignant transformation of a solitary cylindroma involving the fronto-nasal region in a 72-year-old diabetic and hypertensive male reported to the Department of Oral and Maxillofacial Surgery, with a chief complaint of rapidly growing, painful growth over fronto-nasal region for 3-years and difficulty in breathing since 3-months. on examination; a single, large, well circumscribed, tender, firm and fixed multinodular growth with focal areas of ulcerations and reddish brown crustations of approx. 9.0×3.5 cm measuring in its greatest dimension was seen in naso-frontal region. A CECT Head showed a well defined, heterogeneously enhancing lobulated soft tissue mass, occupying the left nasal cavity, ethmoid sinus and extending into medial extraconal space of left orbit. The incisional biopsy report suggested low grade skin adnexal tumor of malignant cylindroma. Based on the finding in the biopsy, the CECT surgical excision of the lesion was planned. The patient was kept on follow-up of 3 years and no local recurrence or distant metastases was noted.

Keywords

• adnexal tumours
• canaliculi
• malignant cylindroma
• microcyst
• multinodular