Sir,

Eccrine syringofibroadenoma (ES) was first described by Mascaro in 19631 and is an uncommon tumour of 
the acrosyringium. Several types of eccrine and apocrine tumours are observed in the eyelids, but ES has not 
been reported previously on the eyelid.

An 84-year-old man attended the eye clinic at Rovereto Hospital, Trentino, Italy, with a solitary, slowly 
growing, well-circumscribed, soft ovoid nodule mass (8 mm diameter) in the right upper eyelid. The 
overlying epithelium was intact. The lesion had been present for several years, and no recent change had 
been noticed. The tumour was removed. The lesion 
appeared to be arising at the eyelid margin, close 
to the mucocutaneous junction. The lesion was 
characterised by multiple downgrowths of squamoid 
or cuboidal epithelial cells which had anastomosed 
around a bland fibroblastic stroma. In many areas, 
there were appreciable formations of multiple small 
ductal structures by these epithelial downgrowths, as 
well as multifocally-scattered mucinous cells [Figure 
1]. No evidence of malignancy was found. A diagnosis 
of ES was determined. The patient was free of disease 
12 months after the excision. 

ES usually affects the extremities of elderly 
individuals, either as a solitary or multiple tumours. 
Multiple lesions have been reported in association 
with Schöpf-Schulz-Passarge syndrome and Clouston 
syndrome.2,3 In our patient, no features of these 
syndromes were found. The overall appearance of ES incorporates aspects of mammary fibroadenoma as 
well as fibroepithelioma of Pinkus (fibroepitheliomatous basal cell carcinoma). The stroma is likely ‘induced’ 
by the epithelial proliferation. It has been suggested that ES is identical to the acrosyringeal nevus of Weedon 
and Lewis,4 but there do appear to be some clinicopathological differences. ES is a benign lesion, and complete 
excision is the treatment of choice.

*Teresa Pusiol, Maria-Grazia Zorzi, Alice Morini
Institute of Anatomic Pathology, Rovereto Hospital, Rovereto, Trentino, Italy 
*Corresponding Author e-mail: teresa.pusiol@apss.tn.it

References
1. Mascaro JM. Considérations sur les tumeurs fibroépithéliales: Le syringofibroadénome eccrine. Ann Derm Syphiligr 

1963; 90:146.

2. Starink TM. Eccrine syringofibroadenoma: multiple lesions representing a new cutaneous marker of the Schöpf 
syndrome, and solitary nonhereditary tumors. J Am Acad Dermatol 1997; 36:569–76.

3. Clouston HR. A hereditary ectodermal dystrophy. Can Med Assoc J 1929; 21:18–31. 

4. Weedon D, Lewis J. Acrosyringeal nevus. J Cutan Pathol 1977; 4:166–8.

Sultan Qaboos University Med J, May 2013, Vol. 13, Iss. 2, pp. 328, Epub. 9th May 13
Submitted 31st Oct 12
Accepted 10th Nov 12

ورم غدي ليفي ناتح يف جفن العني

Eccrine Syringofibroadenoma of the Eyelid

letter to editor

 
Figure 1: The neoplasm (under haematoxylin and 
eosin stain and x 40 magnification) was composed of 
elongated cords growing downward in a fenestrated 
pattern, embedded in the fibroblastic stroma.

Letter to Editor | 328