Carcinoma triquilemal: relato de um caso

Abstract

Tri chilemmal carcinoma is an uncommon low-grade malignant lesion of the outer hair sheath, originating from a hair follicle cell. The differential diagnosis includes other skin carcinomas. This study aims at reporting a case of trichilemmal carcinoma admitted at the Otorhinolaryngology and Head & Neck Surgical Ambulatory, Universidade Regional de Blumenau. The patient was an 86-year-old woman complaining of a reddish lesion on the left supraclavicular region, with one year of evolution and progressive growth, presenting a hardened vegetative mass with central ulceration, blood secretion and local pain. The tumor size was 75x45 mm, which was removed surgically with free margins. Considering that this type of lesion seldom develops metastases or local recurrences, adjuvant therapy was not adopted. The patient has been periodically followed up.Rev Bras Otorrinolaringol. V.70, n.6, 832-5, nov./dec. 2004

Carcinoma triquilemal: relato de caso

“…It affects mainly elderly subjects but is more common between the 4th and 9th decades of life and is not a gender-based illness. 1,[3][4][5][6][7][8] It has also been reported in patients exposed to radiotherapy treatment of benign head and neck diseases with long latency periods, related to the radiation dose to which the patient was subjected. During the 1920 to 1960 decades thymus (a gland that increases in size during childhood and regresses spontaneously) and tonsils radiotherapy was common, for acne treatment and other indications.…”

“…1,2,3,5-10 A differential diagnosis is required and squa- mous cell carcinoma, basal-cell carcinoma, keratoacanthoma and malignant nodular melanoma should be considered. 1,7 However, such lesions are papulonodular, usually reach the reticular dermis, are prone to local recurrence and frequently metastasize. In contrast, the trichilemmal carcinoma presents a slow course and rarely recurs after its excision or metastasizes in other organs.…”

“…In contrast, the trichilemmal carcinoma presents a slow course and rarely recurs after its excision or metastasizes in other organs. 1 Histologically, the tumor is purely intraepithelial or is more commonly associated with an invasive component centered around the pilosebaceous unit, which may reach from the epidermis to subcutaneous fat. 2 They are frequently continuous with the epidermis and the follicular epithelium.…”

“…Immunohistochemistry of the trichilemmal carcinoma is usually negative for CEA (carcinoembryonic antigen) and EMA (epithelial membrane antigen), although late positive results have occasionally been documented. 1,11 The treatment is exclusively surgical. 1,11 Simple excision with adequate margins is safe, inexpensive and effective for the treatment of trichilemmal carcinoma.…”

“…Recently, the publication of some series has contributed to distinguish the TLCA from other groups of follicular tumors. 1 It is considered a carcinoma of low malignancy for presenting low frequency and rare metastases 1 . As a rule, it appears as a solitary lesion after the fifth decade of life.…”