Pediatric Chondroid Syringoma: Systematic Review with High-Frequency Ultrasound Findings
Keywords:
Pediatrics, Chondroid syringoma, High Frequency Ultrasound, Diagnostic Imaging, pediatric dermatologyAbstract
Introduction:
Chondroid syringoma (CS) is a rare adnexal tumor, exceptionally uncommon in children. To date, only isolated case reports exist, and no systematic synthesis has been performed.
Objectives:
We conducted a PRISMA-guided systematic review of pediatric CS and present an illustrative case that provides the first high-frequency ultrasound (HFUS) and elastography findings.
Methods:
PubMed, Scopus, and Web of Science were searched through September 2025. Eligible reports included pediatric patients (<18 years) with histopathologically confirmed CS. Data on demographics, tumor location, diagnostic methods, treatment and outcomes were extracted. In parallel, an 8-year-old girl with CS was evaluated clinically, dermoscopically, and with HFUS and elastography, followed by surgical excision and histopathology.
Results:
The systematic review identified eight pediatric cases in the literature, three malignant and five benign. Most tumors arose in the head and neck region; two occurred in the extremities, including one in association with eccrine spiradenoma. All cases were managed surgically, with favorable outcomes in benign lesions, while malignant cases demonstrated recurrence, metastasis, and one death. Our case presented as a cheek nodule with dynamic dermoscopic changes and HFUS features of a round, lobulated, hypoechoic lesion with posterior enhancement, vascularity, increased stiffness, and a budding yeast–like appearance. Complete excision achieved an excellent cosmetic result without recurrence at one year.
Conclusions:
This study provides the first systematic review of pediatric CS, consolidating current diagnostic and therapeutic knowledge. Our case adds the first detailed HFUS and elastography findings, underscoring the role of imaging as a non-invasive adjunct. Complete excision with long-term surveillance remains the cornerstone of management.
References
Hirsch P, Helwig EB. Chondroid Syringoma: Mixed Tumor of Skin, Salivary Gland Type. Arch. Dermatol. 1961;84(5):835-847. DOI:10.1001/archderm.1961.01580170129018
Yavuzer R, Basterzi Y, Sari A, Bir F, Sezer C. Chondroid syringoma: a diagnosis more frequent than expected. Dermatol Surg. 2003;29(2):179-181. DOI:10.1046/j.1524-4725.2003.29045.x
Di Guardo A, Balampanos CG, Gargano L, et al. Clinical and Dermoscopic Characteristics of Cutaneous Chondroid Syringoma: A Systematic Review. Dermatol Pract Concept. Oct 30 2024;14(4)DOI:10.5826/dpc.1404a237
Headington JT. Mixed tumors of skin: eccrine and apocrine types. Arch. Dermatol. 1961;84(6):989-996. DOI:10.1001/archderm.1961.01580180105016
Hilton JM, Blackwell JB. Metastasising chondroid syringoma. J Pathol. Feb 1973;109(2):167-70. DOI:10.1002/path.1711090210
Botha JB, Kahn LB. Aggressive chondroid syringoma. Report of a case in an unusual location and with local recurrence. Arch Dermatol. Jun 1978;114(6):954-5. DOI:10.1001/archderm.114.6.954
Hermann G, Moss D, Norton KI, Guttenberg ME. Case report 450: Skeletal metastases secondary to malignant chondroid syringoma. Skeletal Radiol. 1987;16(8):657-9. DOI:10.1007/bf00357116
Turhan-Haktanir N, Sahin O, Bukulmez A, Demir Y. Chondroid syringoma in a child. Pediatr Dermatol. Sep-Oct 2007;24(5):505-7. DOI:10.1111/j.1525-1470.2007.00504.x
Nath AK, Kumari R, Thappa DM. Eccrine spiradenoma with chondroid syringoma in Blaschkoid distribution. Indian J Dermatol Venereol Leprol. Nov-Dec 2009;75(6):600-2. DOI:10.4103/0378-6323.57723
Solanki LS, Dhingra M, Bhalla M, Thami GP, Punia RP, Batra S. Chondroid syringoma: report of two cases in young patients. Dermatol Online J. Dec 15 2011;17(12):7.
Purkayastha P, Thomson R, Wilson Jones N, Ng S. Chondroid syringoma: an unusual presentation in a 7-year-old boy. BMJ Case Rep. Jul 26 2021;14(7)DOI:10.1136/bcr-2019-232943
Halder S, Ghosh A, Sharma M, Hemrajani P. Chondroid Syringoma on the Tip of the Nose: A Case Report. Adv Skin Wound Care. Jan 1 2024;37(1):1-4. DOI:10.1097/asw.0000000000000076
Chen AH, Moreano EH, Houston B, Funk GF. Chondroid syringoma of the head and neck: clinical management and literature review. Ear Nose Throat J. Feb 1996;75(2):104-8.
Adlam DM, Wood GA. The chondroid syringoma (mixed tumor of skin). Report of a case in the upper lip. Oral Surg Oral Med Oral Pathol. Jan 1986;61(1):69-72. DOI:10.1016/0030-4220(86)90205-7
Whittle C, Mackinnon J, Cabrera R, Silva C, Pires Y, González R. Finger chondroid syringoma as a hypoechoic subcutaneous nodule in ultrasound. Ultrasound Q. Sep 2013;29(3):211-3. DOI:10.1097/RUQ.0b013e3182a1bf7d
Wortsman X. Common applications of dermatologic sonography. J Ultrasound Med. Jan 2012;31(1):97-111. DOI:10.7863/jum.2012.31.1.97
Wortsman X BM. Common benign non-vascular skin tumors. In: Wortsman X JG, ed. Dermatologic ultrasound with clinical and histologic correlations. Springer; 2013:119-75.
Lin SF, Xu SH, Xie ZL. Calcifying epithelioma of malherbe (Pilomatrixoma): Clinical and sonographic features. J Clin Ultrasound. Jan 2018;46(1):3-7. DOI:10.1002/jcu.22517
Wortsman X. Ultrasound of Common Non-vascular Benign Cutaneous Lesions. Atlas of Dermatologic Ultrasound. Springer; 2018:35-85.
Huang CC, Ko SF, Huang HY, et al. Epidermal cysts in the superficial soft tissue: sonographic features with an emphasis on the pseudotestis pattern. J Ultrasound Med. Jan 2011;30(1):11-7. DOI:10.7863/jum.2011.30.1.11
Horie K, Ito K. Ultrasonographic diagnosis of nodular hidradenoma. J Dermatol. Apr 2016;43(4):449-50. DOI:10.1111/1346-8138.13211
Won KY, Park SY, Jin W, Lew BL. Dermatofibroma: sonographic findings and pathologic correlation. Acta Radiol. Apr 2018;59(4):454-459. DOI:10.1177/0284185117721263
Lallas A, Apalla Z, Ioannides D, et al. Update on dermoscopy of Spitz/Reed naevi and management guidelines by the International Dermoscopy Society. Br J Dermatol. Sep 2017;177(3):645-655. DOI:10.1111/bjd.15339
Di Brizzi EV, Piccolo V, Moscarella E, Pellerone S, Argenziano G. Dermoscopy of pilomatricoma: Retrospective descriptive study on 35 paediatric patients. J Eur Acad Dermatol Venereol. Feb 2025;39(2):e141-e143. DOI:10.1111/jdv.20183
Di Brizzi EV, Moscarella E, Scharf C, Argenziano G, Piccolo V. Dermoscopy of juvenile xanthogranuloma: a retrospective descriptive study on 35 paediatric patients. J Eur Acad Dermatol Venereol. Oct 2022;36(10):e846-e848. DOI:10.1111/jdv.18316
Piccolo V, Russo T, Moscarella E, Brancaccio G, Alfano R, Argenziano G. Dermatoscopy of Vascular Lesions. Dermatol Clin. Oct 2018;36(4):389-395. DOI:10.1016/j.det.2018.05.006
Zaballos P, Carulla M, Ozdemir F, et al. Dermoscopy of pyogenic granuloma: a morphological study. Br J Dermatol. Dec 2010;163(6):1229-37. DOI:10.1111/j.1365-2133.2010.10040.x
Errichetti E, Neri I, Argenziano G, Salerni G, Akay BN, Piccolo V. Dermoscopy of idiopathic facial aseptic granuloma (IFAG): an observational controlled study. Int J Dermatol. Feb 2025;64(2):422-424. DOI:10.1111/ijd.17389
Knöpfel N, Gómez-Zubiaur A, Noguera-Morel L, Torrelo A, Hernandez-Martin A. Ultrasound findings in idiopathic facial aseptic granuloma: Case series and literature review. Pediatr Dermatol. May 2018;35(3):397-400. DOI:10.1111/pde.13324
Ferreiro JA, Nascimento AG. Hyaline-cell rich chondroid syringoma. A tumor mimicking malignancy. Am J Surg Pathol. Aug 1995;19(8):912-7. DOI:10.1097/00000478-199508000-00006
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