Malignant Proliferating Trichilemmal Tumor

Noto, Giuseppe; Pravatà, G; Aricò, Mario

doi:10.1097/00000372-199704000-00017

Cited by 34 publications

(42 citation statements)

References 11 publications

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“…Even for invasive cases and giant tumors, the reported rates of post-operative recurrence and metastasis have been extremely low following conservative, but thorough, excision (2,6). However, other studies consider the biological behavior of tricholemmal malignancy to be difficult to judge, reporting that although numerous patients have undergone local excision and post-operative radiotherapy, recurrence or LN metastasis is frequently found (14–16). An analysis of the prognosis in the present study showed three patients (20.0%) who exhibited neck LN metastasis and three patients who developed recurrence, which included one patient with repeated recurrences.…”

Section: Discussionmentioning

confidence: 99%

Tricholemmal carcinoma of the head and neck region: A report of 15 cases

et al. 2013

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Tricholemmal carcinoma is an extremely rare malignancy of the skin, and its biological behavior and management is controversial. The objective of the present study was to investigate the clinicopathological characteristics and management of tricholemmal carcinoma of the head and neck region. The study analyzed 15 patients with tricholemmal carcinoma. Demographic and clinical data were collected, and features associated with the management and prognosis of tricholemmal carcinoma were analyzed. Two of the 15 patients were lost to follow-up. The results showed that, during the follow-up period, 5 of the 13 available patients succumbed to the causes of recurrence (n=3), neck lymph node metastasis (n=1) and Parkinson’s disease (n=1). No patients developed distant metastasis. The disease-free survival (DFS) and overall survival (OS) were 31.1±7.8 and 32.9±7.4 months (mean ± SE), respectively, and the DFS and OS rates were 69.2 and 61.5%, respectively. In conclusion, the biological behavior of tricholemmal carcinoma is locoregionally aggressive. The recommended management for head and neck tricholemmal carcinoma is radical resection and neck dissection, and post-operative radiotherapy may be considered for high-risk patients.

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Section: Discussionmentioning

confidence: 99%

Tricholemmal carcinoma of the head and neck region: A report of 15 cases

et al. 2013

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“…[56] Alternatively, some authors have recently suggested that PTC is a squamous cell carcinoma. [78910] Nevertheless the malignant potential of these tumors is still debated[11] and new strategies for the evaluation of tumor grade are needed. On the other hand, major association between the presence of ki67 and the grade of malignancy has been observed in all tumors which have been studied by ki67 immunostaining.…”

Section: Introductionmentioning

confidence: 99%

Proliferating trichilemmal cyst: The value of ki67 immunostaining

Rangel-Gamboa¹,

Reyes-Castro²,

Domínguez‐Cherit³

et al. 2013

Int J Trichol

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Background:A proliferating trichilemmal cyst (PTC) is an uncommon, rapidly-reproducing cutaneous epithelial cyst, differentiating from the isthmic portion of the outer hair root sheath. It is usually described as a benign tumor, but malignant transformation has been reported and is then denominated as a malignant proliferating trichilemmal tumor. Ki67 immunostaining has been used as a methodology for the evaluation of tumor grade in other tumors, due to its distinctive reaction patterns which exclusively involve proliferating cells.Objectives:(1) To report the incidence of cases of PTCs in a General Hospital during a 12 years period. (2) To determine the expression of ki67 using immunohistochemical staining. (3) To correlate ki67 reaction patterns with clinical prognosis.Materials and Methods:The dermatology department's files during a period of 12 years were reviewed; cases with a diagnosis of PTC were selected, and ki67 immunostaining was done when enough biological material was available.Results:A total of 15 cases with a diagnosis of PTC were identified. In 12 cases, ki67 immunostaining was carried out. In 9 of the 12 cases, ki67 was observed in the basal cells of the cystic epithelium, one case was moderately positive in palisading epithelial cells; in the other two cases ki67 immunostaining was negative. Clinical follow-up was done and revealed that no patient had local recurrence in 5 years after surgical removal of PTC. We therefore consider this immunostaining technique is probably correlated with low recurrence potential.

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“…13 Immunohistochemical studies and DNA analysis have further defined these pilar tumors. 4,9,10,15 One study found certain pathologic features such as perineural and perivascular invasion, infiltrating growth pattern, necrosis, and atypical mitoses to correlate with high malignant potential, with 4 of 8 patients experiencing recurrence and/or metastasis. 6 In contrast, proliferating tricholemmal cysts with malignant degeneration show aneuploidy 12,14 and increased staining with a proliferative marker not confined to the basilar epithelium.…”

Section: Discussionmentioning

confidence: 99%

Cystic Tricholemmal Carcinoma In Situ

Lin¹

2013

The American Journal of Dermatopathology

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An 89-year-old man presented with a clinically cystic 4-mm papule on the left temple. The clinical impression was a benign cyst. Pathologic examination revealed a small, symmetric-appearing, well-circumscribed, dermal-based cystic lesion with markedly atypical-appearing clear to squamoid cells lining the cyst wall, consistent with carcinoma in situ involving the cyst. The cells showed abundant glycogen-containing cytoplasm (confirmed by Periodic acid Schiff stains with and without diastase), consistent with tricholemmal differentiation, and areas of tricholemmal/pilar-type keratinization (without a granular layer), consistent with tricholemmal carcinoma in situ, most likely arising in a tricholemmal/pilar cyst. Ki-67 and p53 immunohistochemical stains were strongly positive (with more than 20% of nuclei staining on Ki-67 and more than 80% on p53) in the cyst-lining cells, further supporting the interpretation of carcinoma in situ. Multiple deeper level sections were examined but did not show any evidence of an associated invasive carcinoma. Tricholemmal (pilar) cysts are common benign adnexal lesions and atypia/dysplasia or carcinoma in situ arising within them is exceedingly rare. Previously, only one case of a tricholemmal cyst with carcinoma in situ has been reported. That case was associated with an atypical fibroxanthoma. We report only the second case of tricholemmal carcinoma in situ, most likely involving a tricholemmal cyst, which was not associated with another tumor or evidence of invasive carcinoma.

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Malignant Proliferating Trichilemmal Tumor

Cited by 34 publications

References 11 publications

Tricholemmal carcinoma of the head and neck region: A report of 15 cases

Tricholemmal carcinoma of the head and neck region: A report of 15 cases

Proliferating trichilemmal cyst: The value of ki67 immunostaining

Cystic Tricholemmal Carcinoma In Situ

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