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Bluish Papule in a Middle-aged Man—Diagnosis
Arch Dermatol. 2005;141:1595-1600.
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Diagnosis: Cutaneous chordoma (chordoma cutis).
MICROSCOPIC FINDINGS
An expansile myxoid nodule was seen in the dermis. The overlying epidermis was focally eroded, and its rete ridges were effaced. The tumor contained cords of epithelioid cells with eosinophilic cytoplasm in a mucinous stroma. Some cells were large and contained prominent vacuoles that displaced the nucleus to the periphery (physaliferous cells). Immunohistochemical analysis revealed that the tumor cells were positive for S100 protein and cytokeratins and negative for calponin.
DISCUSSION
Chordoma is a rare, locally aggressive tumor of notochordal origin. It arises in the sacrum (50%), spheno-occipital region (35%), or vertebral bodies (15%).1-2 Sacrococcygeal chordoma causes nonspecific back and perineal pain as a result of pressure on surrounding tissues and destruction of soft tissue and bone.1-2 Because of the indolence of its presenting symptoms, chordoma is often diagnosed late in its course. Although it is a slow-growing tumor with a low propensity to metastasize, chordoma has a poor long-term prognosis, . . . [Full Text of this Article]
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Bluish Papule in a Middle-aged Man—Quiz Case
Rachel P. Dubroff, Robert G. Maki, Klaus J. Busam, and Dana L. Sachs
Arch Dermatol. 2005;141(12):1595-1600.
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