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American Journal of Dermatopathology:
doi: 10.1097/DAD.0b013e31824d10e1
Letters to the Editor

Well-Differentiated Malignant Cylindroma

Donner, Ludvik R. MD, PhD

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Department of Pathology, Scott and White Memorial Hospital and Clinic, Scott, Sherwood, and Brindley Foundation, The Texas A&M Health Science Center College of Medicine, Temple, TX

To the Editor:

We have described a locally invasive well-differentiated malignant cylindroma that arose in the mastoid area of an 81-year-old woman.1 She expired 10 years after surgery and did not develop any recurrences or metastases. The tumor superficially invaded the parotid gland and invaded deeply into the periparotid lymph node (Figs. 1 and 2). Although our image of the parotid gland (original Fig. 4) clearly demonstrated a mere presence of neoplastic nests in the parotid gland parenchyma and absence of a solid tumor, our diagnosis was subsequently challenged, and the tumor was proposed to represent a basal cell adenocarcinoma, a parotid gland primary.2 Unfortunately, the latter diagnosis was recently indirectly supported by another article.3 For this reason, all microscopic slides of our case were sent for review to L. Requena, Autonomous University, Madrid, and to L. Cerroni, University of Graz. The case was then discussed during the 8th Summer Academy of Dermatopathology, in Graz, Austria, in July 2011. Both experts agreed with our original diagnosis. We hope that this letter will finally dispel all doubts and uncertainty concerning our article.

Figure 1
Figure 1
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Figure 2
Figure 2
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It is of interest that since the publication of our article, 2 cases of elderly women with locally destructive turban tumors, which were classified as benign cylindromas, were reported.4,5

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REFERENCES

1. Donner LR, Ruff T, Diaz JA. Well-differentiated malignant cylindroma with partially preserved hyaline sheaths. A locally invasive neoplasm? Am J Dermatopathol. 1995;17:169–173.

2. Sangüeza OP. Well differentiated malignant cylindroma. Am J Dermatopathol. 1996;18:107–108.

3. Kazakov DV, Zelger B, Rütten A, et al.. Morphologic diversity of malignant neoplasms arising in preexisting spiradenoma, cylindroma, and spiradenocylindroma based on the study of 24 cases, sporadic or occurring in the setting of Brooke–Spiegler syndrome. Am J Surg Pathol. 2009;33:705–719.

4. Wyld L, Bullen S, Browning FS. Transcranial erosion of a benign dermal cylindroma. Ann Plast Surg. 1996;36:194–196.

5. Friedrich ER. Dermal cylindroma of the scalp (turban tumour) and subjacent calvarian defects. Anticancer Res. 2010;30:1793–1797.

© 2012 Lippincott Williams & Wilkins, Inc.

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