Cylindromas are a type of benign, or non-cancerous, skin growth that originates from specific cells within the skin. These growths typically appear on the scalp and face, though they can develop elsewhere on the body. This article aims to provide a clear overview of cylindromas for a general audience.
What is a Cylindroma?
A cylindroma is a non-malignant tumor that arises from the adnexal structures of the skin, specifically the eccrine sweat glands. These glands are responsible for producing sweat and are found throughout most of the body’s skin.
Under a microscope, cylindromas appear as nests of specialized cells, basaloid cells, arranged in a mosaic pattern. These cell clusters are typically surrounded by a thick, clear layer known as a hyaline basement membrane. This unique cellular arrangement helps pathologists identify the lesion.
While cylindromas are benign, meaning they do not spread to other parts of the body, there are extremely rare instances of malignant transformation. The vast majority of cylindromas remain harmless and localized.
Where Cylindromas Appear and How They Develop
Cylindromas most frequently develop on the head and neck, with a notable predisposition for the scalp. When multiple cylindromas occur on the scalp, they can fuse together, forming large, lobulated masses that may cover a significant portion of the scalp. This specific presentation is sometimes colloquially referred to as a “turban tumor” due to its distinctive appearance.
These growths can appear as solitary lesions or, more commonly, as multiple lesions. The presence of numerous cylindromas is often associated with a genetic condition called Brooke-Spiegler Syndrome. This syndrome is an inherited disorder that also predisposes individuals to other benign skin tumors, such as trichoepitheliomas and spiradenomas.
The development of multiple cylindromas, particularly in Brooke-Spiegler Syndrome, is linked to mutations in the CYLD gene. This gene normally functions as a tumor suppressor, controlling cell growth. When a mutation occurs in the CYLD gene, this regulatory function is disrupted, leading to the uncontrolled proliferation of cells that form cylindromas.
Diagnosis and Treatment of Cylindromas
The diagnosis of a cylindroma typically begins with a clinical examination by a healthcare professional. However, a definitive diagnosis requires further investigation to confirm the nature of the growth. This involves taking a tissue sample for microscopic analysis.
A biopsy, which is the removal of a small piece of the lesion, is performed and then sent to a pathologist. The pathologist examines the tissue under a microscope, looking for the characteristic cellular patterns, such as the basaloid cells and hyaline basement membrane, unique to cylindromas. This histopathological analysis is the gold standard for confirming the diagnosis and ruling out other skin conditions.
The primary and most effective treatment for cylindromas is surgical excision. This procedure involves surgically removing the entire growth, along with a small margin of surrounding healthy tissue, to ensure complete removal. Surgical removal is effective in preventing recurrence at the site of the excised lesion.
Other treatment modalities, such as laser ablation or electrocautery, may be considered for smaller lesions or in specific circumstances, but surgical excision remains the preferred method for most cylindromas. Given their benign nature, the prognosis after complete removal is generally excellent, with individuals experiencing no further issues from the treated lesion.