Chondroid syringoma of the axilla: A potential for misdiagnosis as metastatic carcinoma on fine needle aspiration cytology

Chondroid syringoma is a rare benign adnexal tumor and tends to occur in the head and neck region. Involvement in the axilla is very unusual, and the differential diagnosis of such presentations includes lymphadenopathy and cyst. Fine needle aspiration cytology (FNAC) is a very useful tool for the diagnosis of chondroid syringoma. The characteristic feature of chondroid syringoma in cytology is the presence of distinct biphasic cell populations of epithelial and myoepithelial cells in the chondromyxoid stroma. If the typical biphasic cellular and chondromyxoid stromal elements are not visible in smears, it may be misdiagnosed in cytology. Here, we describe a case of axillary chondroid syringoma that was initially misdiagnosed as a metastatic carcinoma by FNAC. Although chondroid syringoma rarely occurs in the axilla, it should be included among the differential diagnoses of an axillary mass. Cytopathologists need to discern the unique cytological features of chondroid syringoma and avoid misdiagnosis for prompt management of the patient.