Apocrine Mixed Tumor of the Upper Cutaneous Lip: A Case Report

Chondroid syringomas are rare adnexal neoplasms composed of epithelial and mesenchymal components, posing diagnostic challenges due to their diverse histological features. We report an atypical presentation of an apocrine mixed tumor in a 51-year-old female patient who presented with a 0.7 cm firm, flesh-colored nodule on the right lateral cutaneous lip. The patient's clinical findings included significant actinic damage, such as dyschromia, elastosis, lentigines, and actinic keratoses, indicative of chronic sun exposure. Over four months, the lesion increased in size to 1.7 cm x 1.2 cm, warranting surgical excision. Histopathological analysis revealed a cutaneous adnexal neoplasm with follicular and apocrine differentiation, consistent with a chondroid syringoma. The tumor exhibited the characteristic chondromyxoid stroma with areas of myxoid and chondroid components. Mohs micrographic surgery was performed, ensuring complete tumor removal while sparing healthy tissue. A rotational flap closure provided an excellent esthetic and functional outcome, with minimal scarring and no functional impairments reported during follow-up. This case highlights the diagnostic and therapeutic challenges associated with chondroid syringomas, particularly in atypical locations such as the cutaneous lip. The coexistence of chronic photodamage further complicates the clinical picture, emphasizing the importance of thorough histopathological evaluation. Despite the tumor's rarity, timely surgical intervention and meticulous wound management yielded a favorable prognosis. This report underscores the need for clinician awareness to facilitate early diagnosis and appropriate management of rare cutaneous neoplasms, with follow-up care recommended to monitor for potential recurrence.