cylindroma is a benign skin adnexal neoplasm that presents in the head and neck region .
the tumor may be single or multiple , and is commonly located on the scalp .
histopathology is diagnostic with characteristic ' jigsaw puzzle ' architecture and features of ductular differentiation .
a 58-year - old man presented to the outpatient department with the complaints of a painful swelling over the right side of the face and scalp that gradually increased in size since two years . on examination ,
the facial swelling appeared bosellated and fungating , with surface ulceration [ figure 1 ] .
a trucut biopsy was done from the face as well as the scalp nodule [ figure 2 ] .
histopathological examination from both the swellings were identical and revealed lobules of epithelial cells separated by thin acellular eosinophilic septae , which imparted a mosaic or  jigsaw 
the lobules comprised of a peripheral layer of dark staining basaloid cells and pale staining cells in the center .
the periodic acid schiff ( pas ) stain highlighted the acellular basement membrane  like material surrounding the lobules as well as entrapped masses of hyaline material within the lobules [ figure 4 ] , thereby supporting a diagnosis of eccrine cylindroma .
there was no significant family history to support a diagnosis of brooke  spiegler syndrome or familial cylindromatosis .
bosellated and ulcerated swelling on the face low - power view ( h and e 10 ) showing islands of epithelial cells giving a jigsaw puzzle appearance pas stain highlighting the eosinophilic ribbons surrounding the islands and hyaline globules ( h and e 40 )
the cell of origin is from the pluripotent stem cells in the folliculo - sebaceous - apocrine unit .
the tumor continues to incite the curiosity of dermatologists and dermatopathologists , due to its syndromic association as well as due to its unique histopathological appearance .
spiegler syndrome is an autosomal dominant cutaneous tumor syndrome , which presents with multiple skin adnexal neoplasms including cylindromas , trichoepitheliomas , and rarely spiradenomas .
multiple scalp lesions can cover the entire scalp like a turban , earning it the name of turban tumor .
histopathology is diagnostic with islands of cells separated by hyaline basement membrane material that is pas positive .
pas - positive hyaline material in globules is also seen within the lobules . in conclusion ,
this in conjunction with a carefully elicited family history is mandatory to suggest or refute a syndromic association such as brooke  spiegler syndrome .
 cylindroma is a benign skin adnexal tumor of eccrine differentiation . 
 clinically , they are disfiguring lesions that can mimic a malignancy . 
 cylindromas can be single or multiple and commonly involve the scalp ( turban tumor ) and face . 
 multiple cylindromas can have a syndromic association as seen in brooke  
 spiegler syndrome and familial cylindromatosis . 
 we present a case of non familial cylindroma of the face that clinically mimicked a basal cell carcinoma . 
 the histopathology was confirmatory . 
 herein we also highlight the utility of a simple and inexpensive histochemical stain periodic acid schiff in supporting the diagnosis . 
INTRODUCTION
CASE REPORT
DISCUSSION
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