Indian Journal of Pathology and Microbiology

CASE REPORT
Year
: 2016  |  Volume : 59  |  Issue : 2  |  Page : 238--239

Scrotal chondroma in a young male: A rare case report


Sanjeev Kishore, Brijesh Thakur, Sheenam Azad, Sandip Kudesia 
 Department of Pathology, SGRRIM and HS, Dehradun, Uttarakhand, India

Correspondence Address:
Brijesh Thakur
Department of Pathology, SGRRIM and HS, Patel Nagar, Dehradun - 248 001, Uttarakhand
India

Abstract

Soft tissue chondroma is a rare benign, slow growing tumor usually located in hand and foot. Scrotal chondroma is exceedingly rare; chondromas in the pelvic region have also been reported. However, chondroma occurring in the scrotal wall is extremely rare, and only a few cases have been reported worldwide. They should be differentiated from well-differentiated chondrosarcoma. To the best of our knowledge, this is the first case of scrotal chondroma to be reported from India.



How to cite this article:
Kishore S, Thakur B, Azad S, Kudesia S. Scrotal chondroma in a young male: A rare case report.Indian J Pathol Microbiol 2016;59:238-239


How to cite this URL:
Kishore S, Thakur B, Azad S, Kudesia S. Scrotal chondroma in a young male: A rare case report. Indian J Pathol Microbiol [serial online] 2016 [cited 2020 Jan 20 ];59:238-239
Available from: http://www.ijpmonline.org/text.asp?2016/59/2/238/182043


Full Text

 Introduction



Extraskeletal soft tissue chondromas are very rare, slow-growing benign tumors. They constitute approximately 1.5% of benign soft tissue tumors occurring in extraosseous and extrasynovial locations.[1] They are usually seen in hands and feet of adults. Few cases at other sites such as oral cavity, hard palate, preauricular region, vulva, urinary bladder, fallopian tube, prostate, and testis have also been reported.[1],[2],[3],[4],[5],[6] Only eight extraosseous chondromas in the pelvis have been reported in the literature searched; out of which two male cases have been documented in the prostate and testis.[7] We present the third case of extraosseous chondromas in the male pelvis and to the best of our knowledge first case of extraosseous scrotal chondroma reported from India.

 Case Report



A 25-year-old male presented to surgery OPD with multiple nodules over scrotal skin since 3 months. Physical examination showed multiple nodules ranging in size from 1.5 to 2.5 cm in the scrotum. The nodules were firm in consistency, and a few appeared to be hard. There was no skin ulceration. No history of pain, systemic disease, drug administration, local trauma, irradiation, or chronic inflammation was recorded. Clinical diagnosis of multiple sebaceous cysts was made. Intraoperatively, the skin was found to be freely mobile, and both testes and epididymis were normal. Excision of scrotal skin was done and sent for histopathological evaluation.

Grossly, excised skin flap with attached small amount of soft tissue fixed in 10% buffered formalin measuring 8.6 cm 5 cm 1.8 cm was received. The multiple firms, irregular nodules ranging in size from 1.5 to 2.5 cm over skin surface were seen [Figure 1]a. The cut surface of the nodule was solid and creamy white in color. Multiple tissue sections were taken from many areas.{Figure 1}

Three micrometer thick H and E stained sections showed tissue pieces lined by the skin. The epidermis showed normal morphology. Dermis showed multiple, well-circumscribed lesions composed of mature chondrocytes placed in an abundant blue chondroid matrix [Figure 1]b and [Figure 1]c. Nodules of chondroid tissue were separated by fibrous septa. The chondrocytes were bland appearing having well-formed lacunae. Focal areas showed the endochondral type of calcification [Figure 1]d. There was no hypercellularity, cytologic atypia, mitosis, or necrosis. Histological diagnosis of extraosseous scrotal chondroma was made. The postoperative period was uneventful, and there was no evidence of recurrence in 6 months follow-up.

 Discussion



Extraskeletal chondroma also referred to as chondroma of soft parts, is a benign, slow growing soft tissue tumor composed mainly of hyaline cartilage with no connection to bone or periosteum.[8] The tumors occur in males and females with equal frequency, usually seen in fourth to seventh decades of life. Patients usually present with subcutaneous solitary nodule frequently occurring in hands and feet; pain and ulceration may be present occasionally.

Usually, soft tissue chondromas are grossly well-demarcated nodules rarely exceeding more than 3.0 cm in size.[9] Sometimes cut surface shows glassy or myxoid or calcified appearance. On the light microscopic findings, most tumors are composed of mature hyaline cartilage, often showing foci of dystrophic calcification, or metaplastic ossification. Cellularity of the tumor is quite variable, and chondrocytic lacunae also tend to vary in size. Sometimes, marked nuclear atypia, pleomorphism, binucleated, or multinucleated lacunae may be present.[9] The local recurrence rate is about 10–15%.

The etiology of extraskeletal chondroma is uncertain. These lesions can develop from residual embryonal tissue or synovium in the involved area or pluripotent mesenchymal cells undergoing metaplasia, differentiating into cartilage as a result of some irritating stimulus like recurrent trauma or chronic inflammation.[3] However, the exact causal relationship is poorly defined. Pathogenesis and clinical behavior of soft tissue chondromas are still poorly understood, and the knowledge of these neoplasms is mainly based on the evaluation of few documented cases. Some studies have outlined a possible genetic influence in the pathogenesis of soft tissue chondromas particular to chromosome 12 and chromosomes 6 and 11, has been hypothesized in two studies.[10],[11]

It is also important to distinguish chondromas from malignant cartilaginous neoplasms. However, it may be difficult to distinguish between a chondroma and low-grade chondrosarcoma histologically. Some clinical features should raise a suspicion of malignancy, including older age at presentation, rapid growth, and the invasion of surrounding structures. Recurrence or metastasis also helps with the differential diagnosis. Complete excision is recommended for the treatment of extraskeletal chondroma.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

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