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NET LETTER
Year : 2009  |  Volume : 75  |  Issue : 3  |  Page : 330

Giant condyloma acuminata with syringocystadenoma papilliferum


1 Bharati Vidyapeeth University Medical College, Pune - 43, India
2 MMF Joshi Hospital, Pune - 04, India

Correspondence Address:
Vidyadhar R Sardesai
102-Alliance Nakshatra, 48-Tulshibaugwale Colony, Sahakarnagar 2, Pune - 411 009
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0378-6323.51250

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How to cite this article:
Sardesai VR, Agarwal VM, Manwatkar PP, Gharpuray MB. Giant condyloma acuminata with syringocystadenoma papilliferum. Indian J Dermatol Venereol Leprol 2009;75:330

How to cite this URL:
Sardesai VR, Agarwal VM, Manwatkar PP, Gharpuray MB. Giant condyloma acuminata with syringocystadenoma papilliferum. Indian J Dermatol Venereol Leprol [serial online] 2009 [cited 2019 Jun 19];75:330. Available from: http://www.ijdvl.com/text.asp?2009/75/3/330/51250


Sir,

Syringocystadenoma papilliferum (SCAP) is classified as a benign tumor [1] of apocrine differentiation. It either develops independently or is commonly seen in association with nevus sebaceous. [2] Giant condyloma acuminata of Buschke and Lowenstein is a slow growing, locally destructive plaque of unknown origin. It was first described by Buschke and Lowenstein in 1925. It is commonly seen over the penis but is also seen in the anogenital region. It has been associated with human papillomavirus types 6 and 11 and less commonly with HPV types 16 and 18. [3] The association of SCAP and giant condyloma acuminata is rare. The occurrence of condyloma acuminata with SCAP may be related to the environment at the surface of SCAP. [4] We report this case to highlight the rare association of two conditions of different etiologies. Two cases have been reported so far in the literature.

A 30-year-old married woman presented with two asymptomatic skin lesions on medial aspect of the right thigh for last five years. She had similar skin lesion on the same site 12 years back, for which chemical cauterization was done repeatedly, with no response. An excision biopsy was then done. There was a recurrence of lesion on the excision site after six months. The same lesion had gradually increased to attain the present size. Family and personal history were not contributory. Dermatological examination revealed two skin lesions on the medial aspect of the right thigh [Figure 1]. The larger one was 6 7cm in size and smaller one was 1 3cm in size. Both were firm in consistency, non-tender, mobile on the underlying structure, cauliflower-like mass with finger-like projections on the surface.

Results of routine blood investigations and serology for HIV/VDRL/HBsAg were negative.

Histopathological examination of skin biopsy showed changes in condyloma acuminata in the upper part and SCAP in the lower part of the section [Figure 2] and [Figure 3]. Changes of condyloma acuminata were seen as hyperkeratosis, hypergranulosis, koilocytosis in stratum spinosum, and irregular acanthosis with rete ridges converging to the center. Mild mononuclear infiltrate was seen in the dermis. In the lower part of the section, there were changes of SCAP, showing cystic invaginations with numerous papillary projections. Each papilla was lined by two rows of glandular epithelium. The luminal layer was of columnar epithelium covered with eosinophilic active decapitation secretion. The outer layer consisted of cuboidal epithelium. Stroma showed infiltration with plasma cells. DNA probes (AffiProbe test kit) for HPV was negative.

SCAP is an uncommon, benign tumor of disputed histogenesis, with a recent theory suggestive of its apoeccrine origin. Typically, it presents as a hairless plaque on scalp associated with nevus sebaceous. At puberty, it becomes larger, nodular and often verrucous. The uncommon sites of presentation are chest, upper arms, male breast, eyelids, scrotum, and thigh. It could be associated with condyloma acuminata. [4] Rarely, it can also be associated with verrucous tumor. [5] Although, the concurrent occurrence of SCAP and giant condyloma acuminata in this patient may be coincidental, it would seem more likely that the transition zone between the epidermis and epithelium of SCAP provided a site more conducive for infection by HPV 6 and HPV 11 than normal dry, keratinised epidermis. Though confirmation of condyloma acuminata by DNA probes for HPV in this case was negative, the location of lesion and clinicopathological correlation was convincing for superimposed HPV infection to be considered.

 
  References Top

1.Vazmitel M, Michal M, Mukensnabl P, Kazakov DV. Syringocystadenoma papilliferum with sebaceous differentiation in an intradermal tubular apocrine component. Am J Dermatopathol 2008;30:51-3.  Back to cited text no. 1  [PUBMED]  [FULLTEXT]
2.Baykal C, Buyukbabani N, Yazganoglu KD, Saglik E. Tumors associated with nevus sebaceous. J Dtsch Dermatol Ges 2006;4:28-31.  Back to cited text no. 2  [PUBMED]  [FULLTEXT]
3.Heikkinen E, Ranki A. Absence of p53 mutations in benign and pre-malignant male genital lesions with over-expressed p53 protein. Int J Cancer 1998;77:674-8.  Back to cited text no. 3  [PUBMED]  [FULLTEXT]
4.Skelton HG 3 rd , Smith KJ, Young D, Lupton GP. Condyloma acuminata associated with Syringocystadenoma papilliferum. Am J Dermatopathol 1994;16:628-30.  Back to cited text no. 4    
5.Hsu PJ, Liu CH, Huang CJ. Mixed tubulopapillary hidradenoma and Syringocystadenoma papilliferum occuring as verrucous tumor. J Cutan Pathol 2003;30:206-10.  Back to cited text no. 5  [PUBMED]  [FULLTEXT]


    Figures

  [Figure 1], [Figure 2], [Figure 3]

This article has been cited by
1 Pseudocarcinomatous Hyperplasia Associated With Hidradenoma Papilliferum :
Angel Fernandez-Flores, Saul Valerdiz
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2 Syringocystadenoma papilliferum in an unusual location beyond the head and neck region: A case report and review of literature
Yap, F.B.-B., Lee, B.R., Baba, R.
Dermatology Online Journal. 2010; 16(10): 4
[Pubmed]



 

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