Survival study and clinicopathological evaluation of trichilemmal carcinoma

Abstract

Abstract. Trichilemmal carcinoma (TC) is a rare malignancy, commonly located on the scalp, forehead and neck, trunk or the upper extremities. The aim of this study was to investigate the clinicopathological characteristics and prognostic factors of TC, and to determine an optimal treatment strategy for these patients. Consecutive patients who were admitted to the Sun Yat-sen University Cancer Center between 1998 and 2012 were included in this retrospective study. The key prognostic factors affecting survival were lymph node metastasis and surgery margin. Multivariate analysis demonstrated that there was no risk factor for patient survival. Surgery margin and lymph node metastasis were the prognostic factors that influenced the treatment outcome. Simple excision with 1 cm margins is safe, cost-effective and effective for the treatment of TC. Additionally, postoperative follow-up of the patient in order to facilitate early diagnosis of recurrence and distant metastasis is necessary. Systemic chemotherapy should be considered in the case of patients with distant metastases.

Metastatic trichilemmal carcinoma in a patient with breast cancer

“…Wilkie et al 2 suggested using margins for cutaneous squamous cell carcinoma, specifically those that are 4–6 mm in size. Zhuang et al 16 showed improved overall survival in their study when a surgical margin of 1 cm was taken. Mohs micrographic surgery could also be used for excision of TC, as it allows for immediate assessment of surgical margins while preserving as much normal tissue as possible; Kim et al 17 reported no recurrence in 19 months of follow-up when using Mohs micrographic surgery for excision of TC.…”

“…The characteristically indolent nature of TC suggests that a cure is possible with wide local excision 16. There is no current consensus on surgical margins or follow-up for patients with TC.…”

“…There is no data on the utility of radiotherapy, although one patient has been reported to be disease-free after wide local excision and adjuvant radiotherapy 19. Furthermore, no well-defined chemotherapy protocol for advanced TC exists 16. Partial remission with combination cisplatin-cyclophosphamide treatment has been achieved 20.…”

Invasão Intracraniana por Carcinoma Triquilemal

“…Carcinoma Triquilemal é uma lesão maligna rara a qual se origina de células do folículo piloso (bainha externa da raiz do folículo capilar). Acomete indivíduos de ambos os sexos entre 40 e 90 anos de idade 1,3,5,6,7 .…”

“…Não há na literatura tratamento padrão para metástase, porém, alguns sugerem regime quimioterápico para as metástases, como cisplatina e ciclofosfamida (levando à remissão parcial, e não à cura) 3 .…”