Syringocystadenocarcinoma papilliferum of the scalp arising from naevus sebaceous of Jadassohn in adult male from rural Sarawak: A case report

Syringocystadenocarcinoma Papilliferum is an exceptionally rare cutaneous adnexal skin neoplasm of the apocrine or eccrine sweat glands or both. It may progress from pre-existing naevus of Jadassohn. Clinically, the lesion is asymmetrical, ulcerated, nodular, verrucous swelling which could generate various differential diagnosis. Histopathologically, the tumour resemble its benign counterpart, syringocystadenoma papilleferum (SCAP) except that SCACP has variable degree of nuclear atypia and pleomorphism and exhibits numerous mitotic activity. Immunohistochemistry showed different immunoreactivities. Scalp lesions that require wide local excision often cannot be closed primarily due to lack of soft tissue elasticity and therefore, necessitate flap coverage for defect closure. Complete surgical excision with 1cm clear margin is the treatment of choice but chemotherapy or radiotherapy can be offered in patient who refuses surgery or in inoperable cases.