Trichilemmal carcinoma: review of 8 cases

Reis, José; Tellechea, Óscar; Cunha, Miguel F.; Baptista, A. Poiares

doi:10.1111/j.1600-0560.1993.tb01248.x

Cited by 104 publications

(123 citation statements)

References 9 publications

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“…Grossly, the tumors have been described as exophytic, ulcerated, polypoid or nodular lesions that may be keratotic (1). Although the histological features suggest an intermediate to high grade malignancy, TC usually has an indolent clinical course (1). Recurrence or metastasis of this neoplasm has seldom been reported in the medical literature (10)(11)(12).…”

Section: Discussionmentioning

confidence: 99%

“…Women over 40 years of age are the most commonly affected patients. Grossly, the tumors have been described as exophytic, ulcerated, polypoid or nodular lesions that may be keratotic (1). Although the histological features suggest an intermediate to high grade malignancy, TC usually has an indolent clinical course (1).…”

Section: Discussionmentioning

confidence: 99%

“…It originates from the hair follicle cells, and the differential diagnosis includes the other skin carcinomas (3)(4)(5). The common sites include the scalp, forehead and neck, which are sun-exposed areas (1). Women over 40 years of age are the most commonly affected patients.…”

Section: Discussionmentioning

confidence: 99%

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Recurrent and Metastatic Trichilemmal Carcinoma of the Skin Over the Thigh: A Case Report

Sym

Park

et al. 2010

Cancer Res Treat

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I n t r o d u c t i o nTrichilemmal carcinoma (TC) is a rare malignant tumor that develops from the external root sheath of the hair follicle. It usually is found in the skin of the face or ears of elderly women on areas that are exposed to the sun, and TC generally has an indolent clinical course (1,2). This condition is usually curable after a wide excision (2). TC must be differentiated from other skin abnormalities such as squamous cell carcinoma, basal cell carcinoma, keratoacanthoma, and invasive Bowen's disease (3-5). TC is a low-grade carcinoma with a low metastatic potential (6). Surgical excision is considered to be the first choice for curative treatment (7,8), and no other reliable treatment strategies for TC have yet been established (9).We report here on a case of metastatic TC involving the skin over the thigh and this was treated with cisplatin and cyclophosphamide combination chemotherapy. C a s e R e p o r tA 63-year-old woman presented with a mass lesion in the left thigh in September 2006. The medical history and family history were unremarkable. The lesion was 5×5×4 cm in size, with irregular margins and superficial erosion. The entire lesion was removed by performing wide surgical excision and the resection margin was free of tumor. The final diagnosis was TC, and the tumor was composed of several epithelial aggregations arranged in various growth patterns, including solid, lobular and trabecular patterns (Fig. 1). In addition, the skin biopsy revealed that the specimen included neoplastic cells with abundant, clear cytoplasm, and the cells showed prominent atypia and high mitotic activity (Fig. 2).Two years later, the patient was hospitalized with swelling of the left lower leg and enlargement of the left inguinal lymph nodes. The blood pressure was 140/90 mmHg, the pulse rate was 78 bpm, the Trichilemmal carcinoma (TC) is an uncommon cutaneous neoplasm that develops from the external root sheath of the hair follicle. It is considered to be a low-grade carcinoma with low metastatic potential. Local recurrence and metastasis are rare after surgical excision. We report here on a case of metastatic TC in the skin over the thigh, and this tumor was treated with cisplatin and cyclophosphamide combination chemotherapy.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Recurrent and Metastatic Trichilemmal Carcinoma of the Skin Over the Thigh: A Case Report

Sym

Park

et al. 2010

Cancer Res Treat

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“…[74][75][76][77][78][79][80][81][82] Either sex can be affected. The lesion present as a nodular plaque typically o3 cm in diameter, which may have a pale or reddish discoloration, or as an exophytic or polypoid nodule.…”

Section: Clinical Featuresmentioning

confidence: 99%

Malignant adnexal neoplasms

2006

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Malignant cutaneous adnexal neoplasms are one of the most challenging areas of dermatopathology. Tumors of the pilosebaceous apparatus can occur as single-lineage neoplasms or may manifest as complex proliferations with multilineal differentiation patterns including not only the germinative component of the hair bulb, the inner or outer root sheath epithelium and the sebaceous gland and duct, but also the sweat duct components that relate to the apocrine secretory apparatus which empties into the follicle near the follicular bulge. Eccrine and apocrine neoplasms present a bewildering array of morphologies, which often defy precise classification. The purpose of this review is to discuss in detail the malignant neoplasms of the cutaneous adnexae and their benign and prognostically indeterminate mimics. Modern Pathology (2006) 19, S93-S126. doi:10.1038/modpathol.3800511Keywords: eccrine carcinoma; sebaceous neoplasia Malignant tumors of the pilosebaceous apparatus, their mimics and precursors IntroductionTumors of the pilosebaceous unit can occur in isolation or in combination with complex proliferations showing multilineal differentiation patterns encompassing those of sweat ducts, epidermis and stroma with its varied components. In this review, we will focus upon the malignant adnexal proliferations, considering benign entities mainly insofar as they impact the diagnostic approach to adnexal carcinoma. We will first turn to the malignant sebaceous neoplasms, their precursors and their mimics. Sebaceous adenoma Clinical FeaturesThe sebaceous adenoma is a benign neoplasm that manifests clinically as a pale yellow nodular lesion, typically of the face, that expresses itself clinically after the age of 50. Tumors range in size from o1 to 45 cm. [1][2][3][4][5][6] These lesions are associated with the Muir-Torre syndrome, comprising the coexpression of cutaneous neoplasms, including those of sebaceous type with well-differentiated squamous epithelial neoplasms, and visceral malignancies, including carcinomas of the breast, ovary, gastrointestinal tract and larynx. [7][8][9][10][11][12][13][14] An occasional patient may manifest a malignant lymphoma of nodal or extranodal type. 10,12,14 Sebaceous neoplasms in the setting of Muir-Torre syndrome are often difficult to classify, showing overlap features between all of the prototypic forms of sebaceous neoplasm ranging from hyperplasia to carcinoma. 13 HistologyThe prototypic sebaceous adenoma manifests 1-2 layers of germinitive cells which mature to form central sebocytes, and have an architecture comprising a sharply circumscribed sebaceous lobule surrounded by a compressed pseudocapsule of dermal stroma ( Figure 1a). The overlying epidermis may be attenuated, but sometimes forms a collarette around the peripheral aspect of the neoplasm. Unlike sebaceous hyperplasia, occasional mitoses may be seen in the lobules of a sebaceous adenoma and in concert with this nucleoli may be somewhat prominent, but the pleomorphism, hyperchromasia and individual cell necrosis of the se...

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“…4 Trichilemmal carcinoma (TLC) is treated with wide local excision as the lesion is slow growing with no reported incidences of recurrence or metastasis. 23 MPTT needs a wide local excision with a 1 cm margin of normal tissue with regular follow-up. 23 Role of adjuvant radiation and chemotherapy in MPTT is suggested as the tumor has high rates of locoregional recurrence and distant failures due to its aggressive nature.…”

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confidence: 99%

Squamous Cell Carcinoma of the Scalp Masquerading as Trichilemmal Tumor of the Scalp

Naik¹,

Halkud²,

Nanjundappa³

et al. 2014

International Journal of Head and Neck Surgery

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Background: Adnexal components tumors of the skin are very rare and are seen as benign lesions of the scalp in aged women. Trichilemmal tumor is usually benign and rarely under goes malignant transformation in a stepwise manner starting with an adenomatous stage of the trichilemmal cyst to an epitheliomatous stage of the proliferating trichilemmal tumor (PTT) evolving into the carcinomatous stage of the malignant proliferating trichilemmal tumor (MPTT). Case report: A 53yearold woman reported with huge swelling in the posterior region of the scalp. The swelling was mobile and soft to firm in consistency not fixed to the skull bone. The surface was smooth and getting under the swelling was not possible, needle biopsy reported as trichilemmal tumor. Contrast enhanced computed tomography (CECT) neck did not show any nodes in the neck, especially the posterior compartment. The tumor was widely excised with 1 cm margin and the periosteum was kept intact with split skin graft. An area of periosteal adher ence to the tumor seen was excised. The histopathology report on serial sectioning reported grade 1 moderately differentiated squamous cell carcinoma (SCC). Postoperative external beam radiotherapy of 66 Gy was given. The patient is being followed up and no recurrence is seen. Conclusion: Malignant transformation in a proliferating trichilemmal tumor a rare entity and should be differentiated from SCC and the better prognostic trichilemmal carcinoma. A protocolbased adjuvant therapy is available for squamous cell carcinoma but not for trichilemmal carcinoma (TLC) and MPTT. A major metaanalysis may help to establish a clinical outcome based classification and management protocol for these tumors.

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Trichilemmal carcinoma: review of 8 cases

Cited by 104 publications

References 9 publications

Recurrent and Metastatic Trichilemmal Carcinoma of the Skin Over the Thigh: A Case Report

Recurrent and Metastatic Trichilemmal Carcinoma of the Skin Over the Thigh: A Case Report

Malignant adnexal neoplasms

Squamous Cell Carcinoma of the Scalp Masquerading as Trichilemmal Tumor of the Scalp

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