Benign proliferating pilar tumor excised with Slow Mohs surgery: A case report.

Proliferating pilar tumors are rare, benign, exophytic neoplasms, which can closely resemble a squamous cell carcinoma. We describe a patient with a large benign exophytic tumor on the scalp that had been slowly growing over 10 years. While this class of benign follicular tumors is rare, the standard of care is typically excision with clear histologic margins. In this case, this large scalp tumor was surgically excised with clear margins/permanent section margin control using "Slow Mohs" technique, with subsequent repair using a skin substitute dressing, followed by a delayed skin graft.

Intracranial posterior fossa proliferating trichilemmal tumor: first case report.

Proliferating trichilemmal tumors (PTT) are rare benign lesions that predominantly occur in elderly women and usually affect the scalp. They originate from the outer root sheath of hair shafts and have trichilemmal differentiation on histopathological examination. Compared to trichilemmal cysts, PTTs show increased cell proliferation and variable cytological atypia. We report the first case of a patient with an intracranial PTT in the posterior fossa. The clinicoradiological presentation and surgical management of the patient as well as the possible pathogenesis of this tumor are discussed.

Local narrow margin excision sequential with modified ALA-PDT for successful treatment of an 86-year-old patient with malignant proliferating trichilemmal tumor.

Malignant proliferating trichilemmal tumor (MPTT) is thought to represent the malignant counterpart of benign proliferative pilar cyst, a lesion originating from the outer hair root sheath. We report a case of an 86-year-old woman with an exophytic nodule containing an ulcerated surface in the temporal region. Histopathologically confirmed MPTT without metastasis, and considering the risk of metastasis and recurrence, we used single local narrow margin excision combined with modified 5-aminolevulinic acid-mediated photodynamic therapy (ALA-PDT). No recurrence of skin lesions was found in the 2-year follow-up after combined therapy. In conclusion, local narrow margin excision sequential with modified ALA-PDT may be a particularly promising and effective treatment option for MPTT.

Malignant trichilemmal carcinoma misdiagnosed with parotid gland malignant tumor.

Malignat proliferating trichilemmal tumor (MPTT) are rare tumors usually presenting in photo-exposed areas, especially on the face, scalp, neck,and dorsal part of the hand. Differential diagnosis include squamous cell carcinoma, basal-cell carcinoma, keratoacanthoma and malignant nodular melanoma, so that only incisional biopsy can lead to pre-operative diagnosis. We present case MPTT misdiagnosed with parotid gland malignant tumor that underwent radical surgical excision and adijuvant radiotherapy.

Case report: Malignant proliferating trichilemmal tumor of the thumb.

Proliferating trichilemmal tumor is a very rare benign tumor that has the potential to transition into a malignant tumor. PTT most commonly affects the scalps of women above 60 years old and is frequently misdiagnosed due to its rarity. Herein, we present a case of a 68-year-old man with a malignant proliferating trichilemmal tumor on his right thumb. X-ray image showed a soft tissue mass on his thumb accompanied by bone destruction, while 18F-FDG PET revealed a hypermetabolic mass in the first index with axillary lymph node metastasis.

Auricular Malignant Proliferating Trichilemmal Tumor: A Case Report.

Malignant proliferating trichilemmal tumor (MPTT) is a dermal adnexal tumor originated from the external root sheath of hair follicles. In this article, we reported a rare case of auricular MPTT in a 65-year-old male with gradually enlarging and bleeding mass on the right auricle measuring 30 × 20 × 12 mm in size and detailed the surgical strategy for therapy. The diagnosis of MPTT was established primarily by histopathological observation with abrupt keratinization, cytological atypia, abnormal mitoses, and infiltrating margins. Following extensive excision, no recurrence was noted for 14 months. We also discuss its clinicopathological features, differential diagnoses, and treatment methods and review the relevant literature in this regard.

Malignant proliferating trichilemmal tumor of the scalp: report of 4 cases and a short review of the literature.

Malignant proliferating pilar tumors are very rare adnexial lesions that can be confused with other skin neoplasms. The authors present four patients with malignant proliferating trichilemmal tumors located on the scalp. A review of the literature search for malignant proliferating pilar tumors and treatments was performed.

Malignant proliferating trichilemmal tumor in abdominal wall: Report of a rare case at an uncommon site with literature review.

The proliferating trichilemmal tumor (PTT) is a very rare cutaneous neoplasm that rarely is malignant. PTTs mainly occur in the scalp of elderly women. Only 10% occur in places other than scalp. We present a 62-year-old male patient with malignant PTT in his abdominal wall.

Two Cases of Malignant Proliferating Trichilemmal Tumor (MPTT) and Review of Literature.

Malignant proliferating trichilemmal tumors (MPTTs, malignant proliferating pilar tumors) are theorized to originate from the outer root sheath of the hair follicle which resembles the isthmic portion of the hair follicle and epithelium of the lower hair follicle in catagen phase.1 They may develop de novo or arise from a pre- existing trichilemmal cyst or proliferating trichilemmal tumor. The tumors typically present with rapid growth on the scalps of women over the age of 50. In this review, we present two cases of MPTT, presenting on the scalp of a 69-year-old woman and the scalp of a 53-year-old woman. Both tumors were successfully treated with surgery and radiation. In addition to the classic histologic features, pilomatrical differentiation was also seen in case 1, a histologic feature that has rarely been described. In this paper, we review previously reported cases and summarize basic demographics, lesion size, location, treatment method, and patient outcome.

Malignant Proliferating Trichilemmal Tumor: A Subtle Presentation in an African American Woman and Review of Immunohistochemical Markers for This Rare Condition.

A malignant proliferating trichilemmal tumor (MPTT) is thought to represent the malignant counterpart of a benign proliferating trichilemmal cyst, a keratin-filled lesion that derives from the outer hair root sheath. The clinical appearance of MPTTs does not always correlate with their histopathologic behavior, emphasizing the need for biopsy and histopathological analysis. Here, we present a 46-year-old African American woman who was evaluated for an ostensibly benign cyst on her scalp that was diagnosed as an MPTT following histopathological examination. She was treated with simple surgical resection that was flush with the cyst margins, followed by Mohs surgery to ensure complete resection. As immunohistochemistry (IHC) has often been used to characterize MPTTs, we also review the various IHC markers reported in the literature.

TP53 Abnormalities and MMR Preservation in 5 Cases of Proliferating Trichilemmal Tumours.

Proliferating trichilemmal tumours (PTT) are defined by a benign squamous cell proliferation inside a trichilemmal cystic (TC) cavity. A possible explanation of this proliferative phenomenon within the cyst may be molecular alterations in genes associated to cell proliferation, which can be induced by ultraviolet radiation. Among other genes, alterations on TP53 and DNA mismatch repair proteins (MMR) may be involved in the cellular proliferation observed in PTT. Based on this assumption, but also taking into account the close relationship between the sebaceous ducts and the external root sheath where TC develop, a MMR, a p53 expression assessment and a TP53 study were performed in a series of 5 PTT cases, including a giant one. We failed to demonstrate a MMR disorder on studied PTT, but we agree with previous results suggesting increased p53 expression in these tumours, particularly in proliferative areas. TP53 alteration was confirmed with FISH technique, demonstrating TP53 deletion in most cells.

Proliferating Trichilemmal Tumor of the Auricula: A Very Rare Locus.

Proliferating trichilemmal tumor (PTT) is a rare but morphologically characteristic tumor, derived from the external root sheath. They are commonly localized as a solitary lesion on the scalp. They rarely occur in other regions. PTTs generally behave in a benign fashion, up to 20% of the lesions may undergo malignant transformation into squamous carcinoma. We present an elderly woman with a cystic swelling on the crus of auricular helix diagnosed as PTT. To our knowledge, this is the first case in the English literature, of PTT of the auricula.

Management of 3 Proliferating Pilar Tumors: Definition, Differential Diagnosis, and Treatment Options. / Experiencia en el manejo de 3 tumores pilares proliferantes: definición, diagnósticos diferenciales y alternativas terapéuticas.

A proliferating pilar tumor is a rare skin neoplasm that arises from the outer root sheath of a hair follicle. Presentation varies widely, as the tumor can be benign or malignant and has a high probability of recurring after excision. We report our experience managing 3 proliferating pilar tumors with different clinical presentations and pathology findings at Hospital de San José, Bogota, Colombia.

A large helmet-shaped proliferating trichilemmal tumor of the scalp: Is definitive radiotherapy the treatment? A case report.

BACKGROUND: Benign proliferating trichilemmal tumors (PTTs) are a rare entity that arises from the outer root sheath of a hair follicle. They range from a benign PTT that recurs locally to the more aggressive malignant PTT that, in addition to recurring locally, has the potential for metastatic spread. However, as a group, PTTs are slow growing and amenable to surgery. To the best of our knowledge, radical radiotherapy without surgery has been used in only one case in an elderly male patient with good oncological and cosmetic results. CASE PRESENTATION: We present a case of a young unmarried female with a disfiguring PTT of the scalp not amenable to surgery treated successfully with radiotherapy providing good cosmesis. Volumetric modulated arc therapy was used to treat this patient with a dose of 50 Gy in 25 fractions over 5 weeks. A theoretical risk of malignant transformation was explained to the patient. The patient has maintained good cosmesis over the last 12 months with no signs of re-growth. CONCLUSION: In patients with PTT not amenable to surgery, radiotherapy may be an effective alternative providing local control and good cosmesis.

[Exophytic tumor of the scalp]. / Une tumeur exophytique du cuir chevelu.

Proliferating trichilemmal tumor (PTT), still referred to as proliferative trichilemmal cyst (TC), is an uncommon malignant adnexal tumor originating from the cells of the outer root sheath of the hair follicle or, more often, from a trichilemmal cyst, following multiple trauma and/or recurrent inflammation. We report the case of a 64-year old female patient, with no particular previous history, presenting with tumor of the scalp gradually evolving over 18 months. Clinical examination showed a painless, firm, adhering ulcero-budding tumor mass measuring 12 cm along its longer axis at the level of the vertex. The patient had clinically negative lymph nodes. Histological examination showed malpighian cell proliferation arranged in clumps and coalescing lobules with focal areas of abrupt trichilemmal keratinization, with very marked atypies cyto-nuclear and an infiltrated fibrous stroma, suggesting proliferating trichilemmal tumor. Staging evaluation showed no metastase. The patient underwent wide surgical resection followed by in depth removal of extra tissue, without recurrence at 3-months' follow-up.

Malignant Proliferating Trichilemmal Tumor Treated with Radical Radiotherapy: A Case Report and Literature Review.

Reported here is the first case of a malignant proliferating trichilemmal tumor treated with radical radiotherapy. Complete clinical response was achieved, and this obviated the need for aggressive surgery. These tumors have a tendency to develop in older patients, and have a propensity for affecting women more than men. The standard of treatment is surgical excision with a margin of normal tissue. Given that not all patients are good surgical candidates, the role of different treatment modalities in the management of this tumor is discussed.