A malignant chondroid syringoma (also known as a "malignant mixed tumour" or "MCS" ) is a very uncommon cutaneous (skin) condition characterised by an adnexal eccrine tumour. : 667 It is commonly reported to present on the trunk and extremities and behave in an aggressive manner. MCS is a cancerous subtype of its benign counterpart, chondroid syringoma, and is the least common variation that has an approximated prevalence of less that 0.005%. These tumours mainly arise "from sebaceous glands, sweat glands, and ectopic salivary glands" (Tural, Selçukbiricik, Günver, Karışmaz, and Serdengecti, 2013) and are rarely encountered in radiopathological and clinical practice. The tumours commonly appear with an asymptomatic "slow-growing, painless, solid subcutaneous or intradermal nodules with a normal margin" (Obaidat, Alsaad, and Ghazarian, 2007) and make up for less than one percent of all primary skin tumours. Commonly appearing in the limbs and body, these asymmetrical tumours range from two millimetres to more than three centimetres. MCS is one of the rarest subtypes of tumours and usually requires aggressive surgery to terminate. Despite accounting for only a small number of tumours recorded each year, malignant mixed tumours are easily confused with other skin conditions (such as epidermal cyst, pilar cyst, calcifying epithelioma, or a solitary trichoepithelioma (Tural, Selçukbiricik, Günver, Karışmaz, and Serdengecti, 2013)) and have high potential for recurrence after surgical excision. The aggressiveness of malignant chondroid syringoma varies, as 49% of cases have had local recurrence whereas some demonstrate regional lymph node or osseous metastasis.
Removing cerebrospinal fluid at regular 3- to 7-day intervals is the only proven method of significantly reducing intracranial pressure and can be used for symptomatic treatment of headaches. This process may be repeated until improvement is shown. There is growing evidence of moderate quality that suggests corticosteroid therapy using prednisolone or dexamethasone has beneficial effect in treating the CNS symptoms related to A. cantonensis infections. Although early research did not show treatment with antihelminthic agents (parasite-killing drugs) such as thiobendazole or albendazole effective in improving the clinical course of the illness, a number of recent studies from Thailand and China show that the combination of glucocorticoids and antihelminthics is safe and decreases the duration of headaches and the number of patients who had significant headache. Although the addition of antihelminthic agents for management of A. cantonensis infection has a theoretic risk of precipitating a neurologic crisis by releasing an overwhelming load of antigens through simultaneous death of the larvae, no study has shown this to exist in the clinical setting. Additionally, the failure to kill parasites before they attempt to migrate out of the CNS increases the risk of mechanical damage by migrating larvae. Although combination therapy using albendazole and prednisolone has no significant advantage compared to treatment using prednisolone alone in mild cases, the treatment with antihelminthics is demonstrably safe and may have significant benefit for patients with high parasite loads at risk for permanent disability or death.