ABSTRACT
Clear cell SCC is a rare variant of SCC initially reported by Kuo in 1980. A lot of cases of clear cell SCC show intracytoplasmic glycogen deposition and thus need to be distinguished from trichilemmal carcinoma. Although some authors studied the histological features of clear cell SCC, with its limited case reports and the variety of its content, the histopathologic findings of clear cell SCC are still imperfectly known. Herein, we report a case of clear cell SCC with review of literatures for histopathologic findings of clear cell SCC.
Subject(s)
Carcinoma, Squamous Cell , GlycogenABSTRACT
Trichilemmal carcinoma is a rare malignant adnexal neoplasm originating from outer root sheath of hair follicle. It is usually located on sun-exposed, hair-bearing areas of the skin of elderly. Although the tumor may be purely intraepidermal, more commonly it is associated with an invasive component, which may extend to the deep dermis or even into subcutaneous fat. However, involvement of muscular layer or tissue deeper than subcutaneous fat is extremely rare. In general, this tumor appears to have an indolent course. Perineural or perivascular invasion is exceedingly rare. And there are just few cases with local or distant metastasis reported in the literature. We report a case of trichilemmal carcinoma primarily occurring in infraauricular skin with invasion into the parotid gland. It showed perineural involvement of the facial nerve by tumor cells and eventually metastasized to the lung during the period of follow up.
Subject(s)
Aged , Humans , Dermis , Facial Nerve , Follow-Up Studies , Hair Follicle , Lung , Neoplasm Metastasis , Parotid Gland , Skin , Subcutaneous FatABSTRACT
We report a very rare case of trichilemmal carcinoma (TLC) involving the upper eyelid. To the best of our knowledge, this is the first report of trichilemmal carcinoma of the upper eyelid in Korea. A 51-year-old man presented to our hospital complaining of a bloody discharge from his left upper eyelid. He had a soft and lobulated mass on the palpebral conjunctiva. An incisional biopsy revealed trabecular growth of tumor cells with clear cytoplasm, prominent nucleoli, frequent mitoses, and foci of trichilemmal keratinization. Immunohistochemically, the lesion was positive for p53 and negative for CD 34. A diagnosis of TLC was made, and total excision of the mass and reconstruction of the eyelid were performed. Trichilemmal carcinoma is a rare malignant tumor, though it appears to be an indolent neoplasm with no metastatic potential. The treatment of choice for trichilemmal carcinoma of the eyelid is complete excision with tumor-free margins due to the locally invasive nature of the lesion.
Subject(s)
Humans , Male , Middle Aged , Carcinoma, Skin Appendage/pathology , Diagnosis, Differential , Eyelid Neoplasms/pathology , Follow-Up Studies , Hair , Mohs Surgery , Skin Neoplasms/pathologyABSTRACT
Trichilemmal carcinoma is a cutaneous adnexal tumor originating from the outer root sheath of hair follicle, and it was first described by Headington in 1976. Clinically, it usually occurs as an asymptomatic solitary papule, nodule or mass on the face or scalp. This neoplasm is a malignant counterpart of trichilemmoma, and it has been reported in the literature as trichilemmal carcinoma, tricholemmal carcinoma, malignant trichilemmoma, and tricholemmocarcinoma. Although histologically, trichilemmal carcinoma frequently has maliganant features, it has a relatively benign clinical behavior. We think Mohs micrographic surgery is a useful treatment modality in trichilemmal carcinoma because the final skin defect is smaller than a wide excision. We report a case of primary trichilemmal carcinoma which had developed on the face, treated with Mohs micrographic surgery.
Subject(s)
Hair Follicle , Mohs Surgery , Scalp , SkinABSTRACT
Nevus sebaceus is located on the scalp or the face as a single lesion and is already present at birth. In adulthood, various types of appendage tumor may develop secondarily within the lesion of the nevus sebaceus. A syringocystadenoma papilliferum is the most common secondary benign tumor that has been found in 8% to 19% of the lesion of nevus sebaceus. The malignant tumors arising from nevus sebaceus are basal cell carcinoma, squamous cell carcinoma, apocrine carcinoma and malignant eccrine poroma. The combination of a variety of tumor was found in the lesion of nevus sebaceus. We report a case of nevus sebaceus in a 66-year-old male associated with trichilemmoma, trichilemmal carcinoma and trichoblastoma.
Subject(s)
Aged , Humans , Male , Carcinoma, Basal Cell , Carcinoma, Squamous Cell , Eccrine Porocarcinoma , Nevus , Parturition , ScalpABSTRACT
Objective To explore the diagnosis and differential diagnosis of tricholemmal carcinoma and the significance of expression of cytokeratin(CK)and oncogene protein(c-erbB-2)in it.Method Twenty-two cases of tricholemmal carcinoma were studied with histologic and immunohistochemical tech-niques,and compared with those in squamous cell carcinoma.The neoplastic cells were stained with cytok-eratin-H,cytokeratin-L and c-erbB-2immunohistochemically(S-P method).Results The morphological characteristics of the tricholemmal carcinoma were the lobular structure and sudden keratinization in the cen-ter of the lobule,which were the key points to be differentiated with squamous cell carcinoma.The positive rate of cytokeratin-H of tricholemmal carcinoma was81.8%(18/22),and the positive cells distributed in the middle zone between the keratinized lobular center and tumor cells in the peripheral area,which differed from squamous cell carcinoma.Cytokeratin-L expression was not found in tricholemmal carcinoma.The posi-tive rate of c-erbB-2was50%(11/22)in tricholemmal carcinoma,with positive cells distributed to the mar-gin of the carcinoma cell nests,and increased with the poor differentiation.Conclusions The particular dis-tribution of cytokeratin-H suggests the tricholemmal origin of tricholemmal carcinoma.C-erbB-2may take part in the activation and differentiation of this tumor.
ABSTRACT
Trichilemmal carcinoma is a rare malignant neoplasm of the hair follicle, which is derived from or differentiates towards cells of the outer root sheath. We report a case of trichilemmal carcinoma in a 66-year-old woman was presented with an exophytic erosive nodule on the scalp, which was first detected 1 year before. Histopathologically, lobular patterned tumor cells with peripheral palisade of basaloid cells, nuclear atypia, and clear or pale, PAS-positive, diastase-sensitive cytoplasm were observed. In immunohistochemical stain, tumor cells were positive with high molecular weigtht cytokeratin(HMW CK) and negative with CD 34. After the diagnosis, total excision was done. The patient has been free of recurrence or metastasis till now.
Subject(s)
Aged , Female , Humans , Cytoplasm , Diagnosis , Hair Follicle , Neoplasm Metastasis , Recurrence , ScalpABSTRACT
Trichilemmal carcinoma is a rare malignant neoplasm of hair follicle which is derived from or differentiates towards the outer root sheath. Despite the frequent presence of histologically malignant features, it has a relatively benign clinical behavior. We report a case of trichilemmal carcinoma in an 87-year-old woman who showed a solitary slightly tender, 1.5X2cm-sized, verrucous, erythematous nodule with crust on the vertex of scalp. In her past medical history, it had been excised at a private clinic without a histopathological evaluation and recurred 1 year later. Histopathologically, tumor cells showed PAS-positive cytoplasms and cytologic atypia with a few mitotic figures. The patient was treated with a wide surgical excision. She has had no evidence of recurrence or metastasis.
Subject(s)
Aged, 80 and over , Female , Humans , Cytoplasm , Hair Follicle , Neoplasm Metastasis , Recurrence , ScalpABSTRACT
Trichilemmal carcinoma is a rare adnexal tumor originating from outer root sheath of hair follicle. We report a case of trichilemmal carcinoma occurring on the scalp. A 71-year-old women presented with a nodule on the vertex of scalp. Histopathologically, tumor cells showed a lobular proliferation in continuity with the epidermis. The lobules showed peripheral palisading and trichilemmal keratinization. The prominent tumor cells were large cells with PAS-reactive, diastase-sensitive, clear cytoplasm. Striking cytologic atypia and high mitotic index were found. Total excision was done and the patient has been free of recurrence or metastasis for 1 year.
Subject(s)
Aged , Female , Humans , Cytoplasm , Epidermis , Hair Follicle , Mitotic Index , Neoplasm Metastasis , Recurrence , Scalp , Strikes, EmployeeABSTRACT
We report a case of trichilemmal carcinoma in a 82-year-old man who presented an ulcerative tumor. Initially, a crusted mass was observed on the scalp and with subsequent removal of the crust, purulent and ulcerative lesion was seen. After treatment with sensitive antibiotics for 8 days, purulent discharge was markedly decreased in the lesion. Histopathologic findings showed clear cells tumor with trichilemmal keratinization. The tumor cells stained positive to PAS, sensitive to diastase and showed negative findings to CEA, EMA and S-100.
Subject(s)
Aged, 80 and over , Humans , Amylases , Anti-Bacterial Agents , Scalp , UlcerABSTRACT
Trichilemmal carcinoma is a rare malignant neoplasm of the hair follicle, which is derived from or differentiates towards cells of the outer root sheath. We report a case of trichilemmal carcinoma in an 83-year-old female patient. She presented with a tender dome-shaped crusted papule showing a feature of cutaneous horn on the forehead, which was first detected 6 months before. nstopathologically, lobular patterned tumor cells with peripheral palisade of basaloid cells, nuclear atypia, and clear or pale, PAS-positive, diastase-sensitive cytoplasm were observed beneath the marked hyperkeratosis. After the diagnosis, total excision was done. The patient has been free of recurrence or metastasis till now.
Subject(s)
Aged, 80 and over , Animals , Female , Humans , Cytoplasm , Diagnosis , Forehead , Hair Follicle , Horns , Neoplasm Metastasis , RecurrenceABSTRACT
We report a case of trichilemmal carcinoma in a 53-year-old man who presented a nodule on the left preauricular area. The past history revealed that there had been an asymptomatic brownish ulcerative nodule for 5 years. On histological examination, tumor cells showed PAS-positive cytoplasm and cytologic atypia with mitotic figures. Computerized tomography of the lesion showed tumor invasion into the left preauticular area. The patient was treated using a wide surgical excision. Fourteen months after the operntion, recurrence was not found.
Subject(s)
Humans , Middle Aged , Cytoplasm , Recurrence , UlcerABSTRACT
We report a case of Trichilemmal carcinoma in a 75-year-old man who was presented with an exophytic nodule on the lower lip. The tumor was composed of glycogen-rich cytoplasmic cells with PAS-positive, diastase-labile and had a characteristic trichilemmal keratinization. The trichilemmal carcinoma is well known to have originated from the outer root sheath of the hair follicle in the hair bearing area. It is interesting that our case had developed on the lip, an exceptional site for a follicular tumor : the hair follicle could not be seen. It might have been developed from an ectopic follicle or at the follicle of vermillion border and grew up into the lip.
Subject(s)
Aged , Humans , Cytoplasm , Hair , Hair Follicle , LipABSTRACT
Trichilemmal carcinoma is a rare tumor that is located predominantly on sun-exposed skin of the elderly. It is thought to be related to the external root sheath of the hair follicle and the malignant counterpart of a trichilemmoma. We report a case of trichilemmal carcinoma in a 88-year-old woman who had a 10 year history of a single, dark brown tumor on the right preauricular region. In her past medical history, it had been excised twice at a private clinic without a histopathological evaluation and recurred 2 years later. Histopathological findings showed atypical clear cells resembling those of the outer root sheath. Tumor cells showed PAS-positive cytoplasm. Immunohistochemistry revealed positive high molecular weight cytokeratin expression. To our knowledge, this is the second case of trichilemmal carcinoma in the Korean literature. (Ann Dermatol 100) 175178, 1998).
Subject(s)
Aged , Aged, 80 and over , Female , Humans , Cytoplasm , Hair Follicle , Immunohistochemistry , Keratins , Molecular Weight , SkinABSTRACT
We report a case of trichilemmal catcinoma in a 79-year-old woman presentde an atrophic scar remaining after excision of a recurrent nodule on the right mandibular area, Her past history revealed that there had been a painful pea-sized brownish nofule on the same site for two years. Eleven months before presentation, it had been excised but recurred 9 months later. Histopathologic findings showed a clear cell neoplasm with trichilemmal keratinization. The tumor cells showed PAS-positive cytoplasm and cytologic atypia with a few mitoitic figures. Immunohistochemical staining for high molecular weight cytokeratin was positive but carcinoembryonic antigens and epithelial membrane antigens were all negative. To our knowledge this is the first report of trichilemmal carcinoma in Korea.