DOI: https://doi.org/10.36347/sasjm.2025.v11i06.007

Pages: 632-635

Malignant chondroid syringoma is a rare cutaneous tumor of mixed epithelial and mesenchymal origin. It is the malignant counterpart of benign chondroid syringoma and has a potential for local invasion and distant metastasis, although such progression is extremely uncommon. A 60-year-old Mediterranean man presented with a painful, ulcerative 6-cm lesion on his right scapula, progressively enlarging over one year. Biopsy confirmed malignant chondroid syringoma. Imaging revealed local tissue invasion, pulmonary nodules, bone metastases, and spinal cord compression due to vertebral metastases (T1–T4), leading to lower limb weakness and paralysis. The patient was referred for radiotherapy and neurosurgical evaluation. Malignant chondroid syringoma is difficult to diagnose clinically due to nonspecific features. Histological evaluation, especially with hematoxylin and eosin staining, is essential for accurate diagnosis. Immunohistochemistry may support but does not definitively distinguish malignant from benign forms. Treatment involves wide excision with negative margins; however, adjuvant radiotherapy or chemotherapy may be necessary in metastatic cases. The tumor’s unpredictable behavior necessitates long-term surveillance. This case represents the first report from Africa, and only the second globally, of malignant chondroid syringoma presenting with spinal cord compression. Given its aggressive potential, early diagnosis, complete excision, and long-term follow-up are critical. Radiotherapy may be considered for unresectable or metastatic lesions.