Histomorphological Analysis and Clinicopathological Correlation of Tumors and Cysts of Skin and its Appendages – A Retrospective Study at a Tertiary Care Center in Hyderabad

Abstract

Background: Skin tumors and cysts are a heterogenous group of lesions that have varied presentations. It is difficult to diagnose them as benign or malignant lesions as their clinical manifestations tend to overlap. Therefore, histopathological examination serves as the gold standard for diagnosis and proper patient management. Objectives: Histomorphological spectrum of skin tumors and cutaneous cysts and their correlation with clinicopathological diagnoses was evaluated in a tertiary care hospital. Materials and Methods: A retrospective observational study conducted in the department of pathology at CMR institute of medical sciences and hospital, Hyderabad over a period of two and a half years (January 2023 to June 2025). A total of 130 excised skin tumors and cutaneous cysts that were subjected to histopathological examination were included in this study. Inflammation and infection related cases were excluded from the study. The clinical details of the patient were obtained from the pathology requisition forms. Formalin fixed, Paraffin-embedded samples were examined microscopically after hematoxylin and eosin staining. Data analysis was done in Microsoft excel software and Statistical Package for the Social Sciences version 25.0 (IBM Corp., Armonk, NY, USA). Results were presented in frequencies, percentage, mean, and standard deviation. Results: Among the 130 patients studied, 72 (55.4%) were male and 58 (44.6%) were female with a mean age of 37.5 ± 18.4 years (range 1–82 years). Most cases were in the 21–40 year age group (53.1%) and posterior chest region was the most common site involved (23.1%). Epidermoid cysts were the commonest lesions (47.7%), followed by infected epidermoid cysts (13.8%) and papillomas (11.5%). Malignant tumors constituted 7.7% of the total cases studied, with the most common being squamous cell carcinoma. Clinicopathological concordance was seen in 70% of cases while 30% of the cases showed clinicopathological discordance which mainly occurred due to misdiagnosis of epidermoid cysts as sebaceous cysts clinically. Conclusion: Epidermoid cysts were the commonest cutaneous lesions seen among young adults with a slight male predominance. High clinicopathological discordance in this study emphasizes the need for routine histopathological examination to make a precise diagnosis.