A Case of Eyelid Desmoplastic Trichilemmoma

PURPOSE: Desmoplastic trichilemmoma is a rare variant of trichilemmoma first described in 1990. Desmoplastic trichilemmoma on the eyelid has not been previously reported in Korea. We report our experience with a case of desmoplastic trichilemmoma of the eyelid. CASE SUMMARY: A 72-year-old male patient presented with a round mass on the upper eyelid, which was noticed 1 year prior and caused irritation and itching. Excisional biopsy of the mass was performed. Histopathological examination revealed findings suggestive of a desmoplastic trichilemmoma. There was no local recurrence during the 2-year follow-up. CONCLUSIONS: Desmoplastic trichilemmoma should be considered when determining the type of eyelid mass.

Desmoplastic Trichilemmoma Arising in a Nevus Sebaceus

PURPOSE: Desmoplastic trichilemmoma is a rare variant of trichilemmoma. Histologically, it has a typical characteristic of trichilemmoma with epithelium of central portion and dense fibrous interstitium. There are only 4 reported cases of desmoplastic trichilemmoma arised in a nevus sebaceus, so we present a case of desmoplastic trichilemmoma arised in a nevus sebaceus with literature review. METHODS: A 46-year-old female was clinically diagnosed as nevus sebaceous on left side of the forehead. Considering the facial contour, the mass was totally excised elliptically and direct closure was feasible with undermining subcutaneous layer. RESULTS: Pathology report confirmed desmoplastic trichilemmoma developed from a nevus sebaceus and all tumor margins were negative. There were no evidences of tumor recurrence after surgical treatment. CONCLUSION: Desmoplastic trichilemmoma developed from a nevus sebaceus is a very rare tumor. Variant tumors can be developed from nevus sebaceus, so surgeon should be cautious in excising the mass totally and confirm the final pathology report.

A Case of Desmoplastic Trichilemmoma / 대한피부과학회지

Desmoplastic trichilemmoma is a rare variant of trichilemmoma characterized by typical features of trichilemmoma with abundant desmoplastic stroma. We report herein a 54-year-old man presented with 2-year history of a solitary bean sized verrucous nodule on the occipital scalp. Histologically, the tumor showed a well-defined lobular growth extending from the epidermis into the dermis with abundant central desmoplastic stroma. Epithelial lobules at the margins of the neoplasm showed the typical features of trichilemmoma composed of glycogen-rich clear cells and peripheral palisading columnar cells. In contrast, at the center the cells assume a more random pattern of cords and strands traversed by the hyaline stroma, mimicking invasive carcinoma. It was diagnosed desmoplastic trichilemmoma by the distinctive histologic appearance and totally excised.

A Case of Desmoplastic Trichilemmoma / 대한피부과학회지

Desmoplastic trichilemmoma is a rare variant of trichilemmoma and usually occurs as small solitary papules on the face. We report a case of desmoplastic trichilemmoma on the right nostril. The histologic findings revealed well-demarcated lobular growth with central desmoplastic stroma. Periphery of the lesion showed the typical feature of trichilemmoma, whereas the center of the lesion was replaced by dense fibrous stroma.

A case of desmoplastic trichilemmoma / 대한피부과학회지

Desmoplastic trichilemmoma is a rare variant of trichilemmoma. A 46-year-old woman presented with a verrucous papule on the face. Histologically, well-circumscribed lobular growth with abundant central desmoplastic stroma was seen. Peripheral area of tumor lobules showed the usual feature of trichilemmoma, whereas the center of tumor was replaced by irregular cords and nests of basaloid or malpighian cells entrapped in a dense stroma, mimicking invasive carcinoma. It was diagnosed desmoplastic trichilemmoma by the distinctive histologic appearance and totally excised.

A Case of Desmoplastic Trichilemmoma / 대한피부과학회지

The case of an unusual desmoplastic variant of trichilemmoma arising in the face of a 72-year-old man is reported. Desmoplastic trichilemmoma is characterized by the presence of a densely sclerotic stroma, surrounded by lobules of epithelial cells with features of outer root sheath differentiation, including glycogen-rich, clear cytoplasms and peripheral palisading. In the central part of the tumor, irregular cords and nests of epithelial cells entrapped in the desmoplastic stroma are found. The pathological appearance can mimic trichilemmal carcinoma, morpheic basal cell carcinoma, and squamous cell carcinoma. Recognition of this benign neoplasm as such will prevent misdiagnosis and unnecessary aggressive treatment.