Unusual Invasion of Trichilemmal Umors: Two Case Reports

Karameşe, Mehtap; Akatekin, Ahmet; Abacı, Malik; Tosun, Zekeriya; Keskin, Mustafa

doi:10.4236/mps.2012.23014

Cited by 3 publications

(6 citation statements)

References 10 publications

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“…A MPTT is an unusual neoplasm originating from the outer root sheath of hair follicle [4]. The common sites include scalp, forehead and neck.…”

Section: Discussionmentioning

confidence: 99%

“…The common sites include scalp, forehead and neck. Women over 40 years are most commonly affected [4]. Grossly, the tumours have been described as exophytic, ulcerative, polypoid or nodular lesions that may be keratotic.…”

Section: Discussionmentioning

confidence: 99%

“…MPTT usually arise from a pre-existing trichilemmal cyst. MPTTs have a more aggressive and biological behaviour, and these lesions present a significant morbidity and potential mortality [4]. This tumour lacks a distinctive histological or immunohistochemical marker to suggest malignant transformation [4].…”

Section: Discussionmentioning

confidence: 99%

“…MPTTs have a more aggressive and biological behaviour, and these lesions present a significant morbidity and potential mortality [4]. This tumour lacks a distinctive histological or immunohistochemical marker to suggest malignant transformation [4]. The real incidence of MPTT is unknown due to its rarity and also because of its inconsistencies in nomenclature and misclassification as squamous cell carcinoma [2,3].…”

Section: Discussionmentioning

confidence: 99%

“…The real incidence of MPTT is unknown due to its rarity and also because of its inconsistencies in nomenclature and misclassification as squamous cell carcinoma [2,3]. The treatment of choice for MPTT is surgery with periodic surveillance without adjuvant therapy [4]. The differential diagnosis of MPTT includes basal cell carcinoma, sebaceous carcinoma, squamous cell carcinoma and clear cell hydradenocarcinoma [5].…”

Section: Discussionmentioning

confidence: 99%

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Malignant Proliferating Trichilemmal Tumour of the Scalp with Intra-Cranial Extension and Lung Metastasis—a Case Report

2016

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Malignant proliferating trichilemmal tumour (MPTT) is a rare cutaneous tumour predominantly affecting the scalp, eyelids, neck and face of elderly women. It is a large, solitary, multilobulated lesion that may arise within a pilar cyst. These tumours are largely benign, often cystic and are characterized by trichilemmal keratinisation. However at times, the tumour has an aggressive clinical course and a propensity for distant metastasis. We report a case of a 29-year-old male who presented with a scalp swelling. Histology revealed malignant proliferating trichilemmal tumour of scalp. CT thorax showed multiple nodules in both lungs suggestive of lung metastasis. The patient underwent palliative radiotherapy and chemotherapy and expired 2 months after palliation. To the best of our knowledge, malignant proliferating trichilemmal tumour of the scalp with intracranial extension and lung metastasis is a rare condition, and only a handful of cases are reported till date. We report a case of malignant proliferating trichilemmal tumour of the scalp with intra-cranial extension and lung metastasis with relevant discussion at the same time.

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“…A MPTT is an unusual neoplasm originating from the outer root sheath of hair follicle [4]. The common sites include scalp, forehead and neck.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Malignant Proliferating Trichilemmal Tumour of the Scalp with Intra-Cranial Extension and Lung Metastasis—a Case Report

2016

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Giant Aggressive Forehead Tumor: A 15-Year Follow-Up

Challita

Halabi

2019

Clinics and Practice

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Anaesthesia for a “Scalped” Patient

Rizvi

Singh

Sarkar

et al. 2015

JCDR

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A 52-year-old female presented to the Neurosurgery outpatient department for a painless, extensive ulcerative lesion of the scalp, in the occipital region [Table/ Fig-1,2]. The patient had this lesion for the past two years, initially it was the size of a coin however, it gradually progressed to the present size. A provisional diagnosis of Trichilemmal carcinoma of scalp was established after FNAC and the plan was to give a flap cover to the exposed area, along with clearing the Duramater of adhesions and a cranioplasty. Neurosurgeons and Plastic surgeons were involved in the management of the case. Initial lab workup of the case showed a baseline Haemoglobin of 12.2 gm%. Other relevant investigations were within normal limits. Spiral CT scan with 3D reconstruction image [Table/ Fig-3&4] showed that the lesion had invaded into the skull and there was a huge defect in the skull and the brain was lying unprotected in the region of the tumour (without bony skull to protect it).The Duramater could be seen pulsating, reflecting cerebral pulsations. Her weight was 55 kg and relevant airway examination was done, and did not reveal any difficulty in airway management as mouth opening was adequate, full range of neck movements were possible and the Modified Mallampatti Grade was I. Patient was pre-medicated with alprazolam 0.5mg PO, the night before surgery and advised a fast of eight hours for solids and two hours for clear liquids. After wheeling the patient into the operation theatre, standard monitoring was placed as per American Society of Anaesthesiologists (ASA) guidelines (ECG, NIBP, SPO 2 , ETCO 2 after induction, Temperature probe after intubation). The patient was placed in the left lateral position, which she preferred on her own and intravenous access was acquired under local anaesthesia. Preoxygenation was done with 100% oxygen for three minutes prior to induction of anaesthesia. She was co-induced with intravenous midazolam 1mg followed by intravenous Fentanyl 100mcgs and thiopentone 5mg/kg titrated, to eyelash reflex. Prior to administration of vecuronium 0.1mg/kg, adequate bag and mask ventilation (BMV) was confirmed. After administration of vecuronium, patient was ventilated for 5 minutes, to attain good intubating conditions. After this, direct laryngoscopy was done in the lateral position, revealing a Cormack and Lehane Grade I of the glottis. The trachea was intubated smoothly and swiftly with a flexo-mettallic endotracheal tube (7.5 ID). Tracheal intubation was confirmed with auscultation and end-tidal capnography (ETCO 2 ).Endotracheal tube was secured nicely with tincture benzoin and Dura pore adhesive tape. A Central venous catheter (CVC) 7 French, triple lumen was placed in the right internal jugular vein under ultrasonography (USG) guidance in the lateral position, as the surgery was presumed to be quite extensive and lengthy. Left radial artery was cannulated and arterial blood pressure was obtained by means of transducer. A Foley's catheter was passed aseptically and urine output was monitore...

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Unusual Invasion of Trichilemmal Umors: Two Case Reports

Cited by 3 publications

References 10 publications

Malignant Proliferating Trichilemmal Tumour of the Scalp with Intra-Cranial Extension and Lung Metastasis—a Case Report

Malignant Proliferating Trichilemmal Tumour of the Scalp with Intra-Cranial Extension and Lung Metastasis—a Case Report

Giant Aggressive Forehead Tumor: A 15-Year Follow-Up

Anaesthesia for a “Scalped” Patient

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