Hondroidny siringoma (mutsinozny gidradenoma) – a solitary hondroidno-epitelialny tumor of skin of the good-quality nature. Primary elements are the small small knots of a plotnoelastichesky consistence appearing spontaneously on the trunk skin which is not changed earlier. They tower over level terms, have a smooth surface, have slow peripheral growth, izjyazvlyatsya sometimes. Diagnostics is performed by the dermatologist on the basis of the anamnesis and clinical manifestations with use of results of histology, skarifikatsionny dab from the center of defeat and a punktat of a new growth. Treatment consists in surgical or electrosurgical excision of a hondroidny siringoma.
Hondroidny siringoma – a benign tumor of ekkrinny sweat glands of the mixed genesis. Heterogeneity of a hondroidny siringoma, according to most of dermatologists, is caused by the fact that the ekkrinny sweat gland is in a term, but its channel opens on the surface of skin. Possibly, the mixed type of cells of tumor is explained by it, however absolutely reliable confirmations of such genesis are absent. In dermatology P. Abenoza and A. Akkerman who from 1979 to 1987 investigated more than 800 thousand biopsies of tumors of sweat glands were engaged in studying of sweat glands and found in them only 5% of ekkrinny pathology. It testifies in favor of a rarity of a hondroidny siringoma and explains its weak study. The Hondroidny siringoma has no age, seasonal, climatic and geographical features. Various authors interpret a gender component in different ways that is connected with the mixed tumor type. One options of a hondroidny siringoma meet at women, others more often – at men. Relevance of a problem is connected with insufficient study of a neoplasia and a possibility of its transformation in a malignant siringokartsinoma.
Reasons of a hondroidny siringoma
Triggers of pathological process and the mechanism of its development are almost not studied. For the unknown endogenous or exogenous reasons at a hondroidny siringoma regeneration of the section of the output canal of an ekkrinny sweat gland passing through all layers of epidermis and opening on the surface of skin spontaneously begins. Connecting fabric owing to the lability, multifunctionality, polymorphic cellular structure and close connection with immune system joins in this process. There is an increase in speed of mitotic cell fission and their maturing. The differentiation of cages is broken, their functions change.
Cages begin to produce the substances unusual for them reminding cartilaginous tissue which forms hondromukoidny to Strom tumors. As cages of a hondroidny siringoma on differentiation level slightly differ from normal cages terms, the tumor of the good-quality nature is formed. Touch between cellular elements is at the same time lost, proliferative processes amplify. As the mass of cages grows on the limited site, the tumor on the surface of skin in the form of a hondroidny siringoma – a good-quality small knot is formed. The injured ekkrinny sweat gland ceases to work that leads to local violation of process of sweating.
Classification and symptoms of a hondroidny siringoma
In modern dermatology there is no standard classification of pathological process, however practical dermatologists for definition of degree of danger of an ozlokachestvleniye of a hondroidny siringoma and timely purpose of adequate therapy use the classification of a disease made taking into account histologic signs. On existence of flat cages in a hondroidny siringoma V. Lever and G. Shaumburg in 1983 allocated two possible options:
1. The Tubulyarny type is characteristic of a hondroidny siringoma which elements consist of two layers of epitelialny cages – internal prismatic and external flat, inclined to proliferation and reproduction of a hondroidny matriks, that is capable to regeneration.
2. The cystous type is characteristic of a single-layer hondroidny siringoma at which Strom there are basophiles and mukoidny substances, but there are no flat cages that defines high quality of a tumor.
Primary elements of a hondroidny siringoma are small oval painless pinkish small knots with a glossy surface. Opukholevidny educations settle down vnutridermalno or slightly tower over the surface of skin. They pasty to the touch are also localized where there are sweat glands. Most often the hondroidny siringoma debuts on trunk skin. Small knots have slow growth, are capable to grow for years, seldom exceed 5 mm in the diameter, sometimes have a translucent cover, are capable . Emergence of primary elements is not followed by subjective symptomatology or emergence of the expressed cosmetic defect and long time remains unnoticed for the patient that is dangerous from the point of view of a possibility of transformation of a tumor in siringokartsiny.
Diagnostics and treatment of a hondroidny siringoma
The clinical diagnosis of a disease the dermatologist on the basis of the anamnesis gives and marks of symptoms in dynamics with emphasis on sweating malfunction. The diagnosis of a hondroidny siringoma demands obligatory histologic confirmation. As a part of a tumor find presence of epitelialny cages and growth of connecting fabric with sites of mutsinozny and hondroidny inclusions. Apply a research of a punktat of a small knot or a biopsy. Use cytology of dabs-skarifikatov from nodular rashes (by analogy with dabs prints at a puzyrny dermatosis). They allow to find akantolitichesky cages in a tumor. Differentiate a hondroidny siringoma with the mixed tumor of salivary glands, bazaliomy, siringokartsinomy.
At good-quality option of a hondroidny siringoma treatment is not required. The purpose of possible therapy is correction of esthetic defect. Radical removal of a hondroidny siringoma is necessary at emergence of the first signs of an ozlokachestvleniye: erozirovaniye of a surface of a small knot, korkoobrazovaniye. Consultation of the oncologist, surgeon and cosmetologist after which removal of a hondroidny siringoma by surgery can be made is obligatory. Apply electroexcision, an elektrokauterization, laser coagulation, a surgical curettage. It is necessary to remember that removal of a tumor can lead to hyper scarring, a hyperpegmentation, formation of a resistant eritema therefore at esthetic correction of a tumor with use of operational techniques it is necessary to consider localization of pathological process. The forecast is favorable.