Report of a Case of Challenging Lesion in Buccal Area with Review of Literatures

Chondroid syringoma is a relatively rare cutaneous mixed tumor arising from sweat gland and pleomorphic adenoma or benign mixed tumor is the most common salivary neoplasm. Because of morphologic and histopathologic similarities between chondroid syringoma and pleomorphic adenoma, these two lesions were previously considered together, however these tumors should not be mistaken with each other and must be differentiated from each other. The aim of this case report was to present a challenging lesion in buccal area of uncertain origin along with discussing about contributing features for defining the origin of lesion and accordingly its diagnosis. CASE: The lesion belongs to a 45 year old female with complaint of a mass in right buccal area that was surgically excised and submitted for histopathologic assessment. Histopathologic features were compatible with a mixed tumor and differentiation between a salivary gland pleomorphic adenoma and sweat gland chondroid syringoma was very difficult that along with discussing about their differences and similarities, we present our reasons for attributing this lesion to each of the above-mentioned diagnoses. After two years of patient's follow-up, recurrence of the lesion was not observed.

Some features such as age, gender, presence of follicular or sebaceous differentiation, amount of keratinization, presence of single-layered ductal structures, presence of hyalinized stroma, presence of fatty tissue, presence of hyaline cells, presence of tyrosine-rich crystalloid and to some extent immunohistochemical staining could help in differentiation of chondroid syringoma from pleomorphic adenoma.