ABSTRACT
Proliferating trichilemmal tumor (PTT) is an uncommon neoplasm originated from the outer root sheath of a hair follicle. Malignant transformation occurs occasionally in proliferating trichilemmal tumors, which can be manifested by sudden rapid growths. Histologically, the malignant proliferating trichilemmal tumors (MPTTs) have shown severe nuclear atypia, marked cellular pleomorphism with atypical mitoses, dyskeratotic cells and infiltrating margins. Squamous cell carcinoma (SCC) should be differentiated with MPTT which indicates characteristic trichilemmal keratinization. Large tumor is considered as a risk factor of metastasis in SCC, but the relationship between tumor size and metastasis in the MPTT is not yet clarified. In this report, two patients have large erythematous nodules with focal ulceration and necrosis on their scalps and were diagnosed as MPTT. Despite the large sizes of the tumors, there were no evidences of metastases. Herein, we report 2 cases of the large MPTT which are presented without metastasis.
Subject(s)
Humans , Carcinoma, Squamous Cell , Hair Follicle , Mitosis , Necrosis , Neoplasm Metastasis , Risk Factors , Scalp , UlcerABSTRACT
PURPOSE: To report the case of recurred malignant proliferating trichilemmal tumor on scalp METHODS: Case report and literature review RESULTS: A 40-year-old man presented with a recurred malignant proliferating trichilemmal tumor, which developed on the occipital area. It was 8 x 9 x 4.5 cm in size, protruded, firm and non-tender mass. This tumor was widely excised including normal skin margin and pericranium. Immediate reconstruction using free latissimus dorsi muscle flap and skin graft were done. Histopathologic examination revealed abrubt, compact trichilemmal keratinization in the central area of lobular epithelial proliferation. CONCLUSION: There has been no recurrence of tumor during follow-up period of nine months without adjuvant chemotherapy or radiotherapy.
Subject(s)
Adult , Humans , Chemotherapy, Adjuvant , Follow-Up Studies , Radiotherapy , Recurrence , Scalp , Skin , Superficial Back Muscles , TransplantsABSTRACT
Proliferating trichilemmal cyst(proliferating trchilemmal tumor, PTC) most commonly occurs in the scalp and is generally benign. Malignant transformation of PTC is rare, and the appearance of a spindle cell(sarcomatoid) carcinoma is extremely rare. The authors experienced a case of malignant proliferating trchilemmal tumor with spindle cell carcinoma on the scalp in a 41-year-old male. The tumor was widely resected and covered with split thickness skin graft after Terudermis(R) graft. Imaging studies and fine needle aspiration cytology showed no regional lymph node involvement or distant matastasis.
Subject(s)
Adult , Humans , Male , Biopsy, Fine-Needle , Lymph Nodes , Scalp , Skin , TransplantsABSTRACT
Malignant proliferating trichilemmal tumor is a rare neoplasm derived from the outer root sheath of the hair follicle. We report a 64-year-old woman with nodular mass in her scalp of for 10 years. Despite surgical removal of the mass, the residual lesion grew with ulceration. In fine needle aspiration, malignant cells were detected. Histological examination of the skin lesion revealed a lobulated tumor exhibiting keratinization beneath the epidermis. In some area, cord of atypical cells infiltrating surrounding tissue, stromal desmoplasia, mitotic figures were seen. For treatment wide surgical excision and skin graft were done.
Subject(s)
Female , Humans , Middle Aged , Biopsy, Fine-Needle , Epidermis , Hair Follicle , Scalp , Skin , Transplants , UlcerABSTRACT
A 32-year-old man was admitted to our hospital due to a headache. A brain CT and MRI showed a parenchymal mass in the right temporoparietooccipital lobe and histopathological specimens demonstrated a proliferating trichilemmal tumor (PTT). Two years prior to experiencing headache, the man had a round mass localized in the right suboccipital scalp which recurred after wide excisions and was found to be PTT. There was no evidence of tumor recurrence at the scalp during the period the man first began experiencing headache. Although PTT usually occurrs at the scalp, direct invasion into the brain is very rare. We report a patient with malignant PTT who developed brain parenchymal inva-sion, which was supported by neuroradiological and histopathological findings.