Multiple Trichilemmal Cysts of the Scalp

Abstract

Different entities can be the cause of scalp neoplasia. In a phenotype with multiple cystic scalp lesions, the diagnosis must be made with particular caution because the appearance of apparently benign tumors does not necessarily correspond to the biological behaviour of the lesions. This case report describes diagnosis and therapy of a patient with multiple cystic tumors confined to the scalp. Diagnosis of benign lesions all over the scalp allowed an aesthetically pleasing surgical treatment result. Long-term follow-up control was offered to the patient because the histological diagnosis identified further small tumors of the same type as the large lesions, so further neoplasms are likely to develop.In the scalp, very different neoplasms can arise, which differ greatly in biological behavior. In rare cases, cysts or cyst-like lesions may develop in the scalp, as large exophytic tumors and are visually perceived to be neoplasias. The distinction of cystic scalp lesions has been controversial until recently. Histogenetic aspects are highlighted in the diagnosis of cysts and cyst-like lesions of the scalp (1-3). Cystic lesions of the scalp require careful examination because malignant tumors can develop from these lesions (4-6). This report describes a rare case of multiple nodular and partially cyst-like lesions of the scalp, initially thought to be schwannomas.

Flecked Calcifications in Scalp Tumors: Two Cases of Giant Ulcerated Trichilemmal Cysts

“…Radiologically they appear as sharply defined hypodense or mixed density masses on CT scan with areas of calcification and mineralization in them that classically help to distinguish them from other scalp tumors. 4 5 Unless there is malignant transformation these lesions do not show any calvarial erosion, periosteal reaction, and are well demarcated without other soft tissue infiltration, 4 5 helping to differentiate them from bony erosive lesions.…”