Bilateral heel eccrine syringofibroadenoma treated with serial cryotherapy

Abstract

Eccrine syringofibroadenoma (ESFA) is an uncommon benign adnexal neoplasm. Although it most frequently manifests on the lower extremities, particularly at acral sites, its various subtypes can result in diverse clinical presentations. Here, we report the case of a 49-year-old male presenting with a 14-year history of bilateral heel lesions. The right heel exhibited a hyperkeratotic, erythematous, and edematous plaque with focal erosion that had progressively worsened, accompanied by a burning sensation and intermittent serous discharge. Histopathological analysis revealed anastomosing epithelial cords with eccrine ductal differentiation within a fibrovascular stroma, thus confirming the diagnosis of ESFA. Due to the weight-bearing nature of the bilateral heel involvement, which posed considerable challenges for postoperative wound care, serial cryotherapy was chosen for this case. Following multiple sessions, the lesions exhibited substantial regression, characterized by plaque softening and localized scar formation.