Chondroid Syringoma of the Nasal Ala: A Case Report

Chondroid syringoma, also known as mixed tumor of the skin, is a rare benign cutaneous adnexal neoplasm characterized by both epithelial and mesenchymal differentiation. It most commonly occurs in the head and neck region and usually presents as a solitary, slow-growing, painless dermal or subcutaneous nodule. Because of its nonspecific clinical and dermoscopic presentation, the diagnosis is rarely suspected before histopathological examination. We report a case of a 73-year-old male with no significant medical history who presented with a progressively enlarging flesh-colored nodule of the nasal ala evolving over one year. Clinical examination revealed a well-demarcated, firm, painless, round nodule measuring 7 mm in diameter, adherent to the overlying skin, with a smooth surface. Dermoscopic examination revealed a central pigmented structureless area, peripheral white dots, linear vessels, and whitish areas, resulting in a nonspecific dermoscopic pattern. The main clinical differential diagnoses included nodular basal cell carcinoma, epidermal inclusion cyst, amelanotic nevus, neurofibroma, and chondroid syringoma. An excisional biopsy was performed. Histopathological examination showed a benign adnexal tumor composed of numerous ductal and tubular epithelial structures embedded within a myxoid to chondromyxoid stroma, consistent with chondroid syringoma. Surgical margins were free of tumor. No recurrence was observed after two years of follow-up. This case highlights the importance of considering chondroid syringoma in the differential diagnosis of long-standing nodular lesions of the nose and emphasizes the role of complete surgical excision and histopathological confirmation.