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Case Reports

Abstract

True cutaneous chondroma, or chondroma cutis, is a rare benign neoplasm composed of well-circumscribed hyaline or myxoid cartilage within the dermis, without connection to underlying skeletal structures. Classified among extraskeletal chondromas, these lesions are usually congenital but may also occur later in life. Histopathologic overlap with other lesions poses a diagnostic challenge, as chondroma cutis is uncommon yet readily curable, making accurate identification essential. We report a 77-year-old male with a firm nodule on the anterior left nostril, clinically resembling nodular basal cell carcinoma. Histologic evaluation showed a benign nodular cartilaginous proliferation confined to the dermis, without epidermal connection or malignant features. The nasal location is unusual, as it is more often associated with sebaceous hyperplasia or angiofibroma. While a synovial origin has been proposed for soft-tissue chondromas due to their proximity to tendons and joints, their occurrence in sites prone to sebaceous hyperplasia or angiofibroma supports alternative, yet unproven, pathogenic theories. The differential diagnosis includes cartilaginous hamartomas such as Meckel’s cartilage remnants and accessory tragus; skeletal tumors with cartilaginous differentiation; juvenile aponeurotic fibroma; chondroid syringoma; and cutaneous metastases from chondrosarcoma or chondroblastic osteosarcoma. Cartilaginous hamartomas are typically congenital, occur in the head and neck, and contain both cartilage and vellus hair follicles. Distinguishing benign from low-grade malignant cartilaginous tumors may be difficult. Surgical excision is the treatment of choice and offers an excellent prognosis with low recurrence risk. This case underscores the need for careful histologic evaluation of dermal cartilaginous lesions, particularly in rare locations.