High‐grade trichoblastic carcinoma arising through malignant transformation of trichoblastoma: Immunohistochemical analysis and the expression of p53 and phosphorylated AKT

Fusumae, Takayuki; Tanese, Keiji; Takeuchi, Asako; Takasugi, A.; Kawakita, Rino; Shiraishi, Junichi; Yoshida, Tetsuya

doi:10.1111/1346-8138.14686

Cited by 13 publications

(11 citation statements)

References 10 publications

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“…The low‐grade form contains atypical basal cells, and has an indolent clinical course with little propensity to metastasize. The high‐grade form contains malignant basal cells with associated inflammation and higher metastatic potential …”

Section: Discussionmentioning

confidence: 99%

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Trichoblastic carcinosarcoma: A case report and literature review

et al. 2019

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Trichoblastic carcinosarcoma is a rare biphasic adnexal neoplasm. This case report chronicals the eighth occurrence of this tumor published in the English literature and provides a review of the prior publications. Clinically, this tumor presents as an isolated, rapidly growing lesion in elderly patients and is usually cured by complete surgical excision, with no evidence of recurrence or metastasis at follow‐up (7/8 cases). Histopathologically, trichoblastic carcinosarcoma is dermal‐based, with an epithelial component of basal cells and a mesenchymal component of spindle cells, both of which display malignant features. In addition to a morphologic description of trichoblastic carcinosarcoma, a discussion of the differential diagnoses, including other biphasic neoplasms, is also included. The small number of cases of trichoblastic carcinosarcoma is most likely secondary to under‐recognition and underreporting and a larger case volume is needed to more accurately assess the clinical course and treatment strategies.

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Section: Discussionmentioning

confidence: 99%

“…The high-grade form contains malignant basal cells with associated inflammation and higher metastatic potential. 1,12 Trichoblastic sarcoma is an exceedingly rare biphasic neoplasm.…”

Section: Discussionmentioning

confidence: 99%

Trichoblastic carcinosarcoma: A case report and literature review

et al. 2019

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“…Their overall behaviour appears to be indolent. In contrast, high‐grade trichoblastic carcinomas present as large and often ulcerated nodular tumours, occurring sporadically or as malignant transformation of trichoepitheliomas in patients with Brooke–Spiegler syndrome 1,2,8–12 . Histopathologically, they are characterised by expansile nodular growth of undifferentiated carcinoma arising in a background of a benign trichoblastoma or trichoepithelioma.…”

Section: Discussionmentioning

confidence: 99%

“…Their behaviour appears to be indolent, with local recurrence occurring only rarely. In contrast, morphologically high‐grade trichoblastic carcinomas are defined as undifferentiated carcinomas arising in a background of a trichoblastoma or trichoepithelioma as a benign precursor 1,8–12 . These tumours present as nodules, often measuring multiple centimetres and showing epidermal ulceration, and they show a wide anatomical distribution, affecting the trunk and the extremities, and less commonly the head and neck area.…”

Section: Introductionmentioning

confidence: 99%

Morphologically high‐grade trichoblastic carcinoma: a clinicopathological study with long‐term clinical follow‐up

et al. 2021

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Aims Trichoblastic carcinomas (malignant trichoblastomas) are rare and poorly documented neoplasms characterised by malignant transformation of a pre‐existing benign trichoblastoma, and are subdivided histologically into low‐grade and high‐grade tumours. Whereas morphologically low‐grade trichoblastic carcinomas show indolent behaviour, morphologically high‐grade trichoblastic carcinomas have been associated with a poor prognosis, but little is known about their true biological potential. The aim of this study was to better define the clinicopathological features and outcomes of morphologically high‐grade trichoblastic carcinomas. Methods and results Four high‐grade trichoblastic carcinomas were retrieved from departmental files, and the clinical and histopathological features and follow‐up were recorded. The tumours presented as nodules on the scalps, necks and shoulders of adults (median age, 40 years; range, 30–55 years) with a female predominance of 3:1. Three patients had a longstanding history with recent change. Histologically, three tumours were characterised by an expansile cellular nodule composed of sheets of pleomorphic epithelioid cells with brisk mitotic activity and necrosis arising in a background of a benign trichoblastoma. One tumour showed a more gradual transition from a benign trichoepithelioma to an undifferentiated carcinoma with infiltrative growth and perineural infiltration. All patients were alive with no evidence of recurrence or metastasis following complete excision after a median follow‐up of 96 months (range, 30–180 months). Conclusions The correct diagnosis of high‐grade trichoblastic carcinoma relies on adequate sampling and recognition of the benign trichoblastic precursor lesion, i.e. trichoblastoma or trichoepithelioma. Despite the concerning histological features of the malignant component, the tumours appear to be less aggressive than previously thought.

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“…Expression of EGFR has also been reported in several sweat gland carcinomas (104). In addition, expression of HER2 (105–107) and c-KIT (108, 109) and the activation of MAPK or PI3-AKT signaling pathways have been described in single case reports of several skin adnexal carcinoma types (108–110).…”

Section: Skin Adnexal Carcinomamentioning

confidence: 99%

Updates on the Systemic Treatment of Advanced Non-melanoma Skin Cancer

et al. 2019

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Non-melanoma skin cancers (NMSCs), which represent a diverse group of cutaneous malignancies, are the most common forms of human neoplasia. The incidence of these diseases is increasing due to a number of factors, including that of increasing human lifespans. The majority of NMSCs are basal cell carcinomas (BCC) and cutaneous squamous cell carcinomas (cSCC), with the remainder being various rare skin cancers, including extramammary Paget's disease (EMPD), Merkel cell carcinoma (MCC), and several skin adnexal carcinomas. Of these, MCC usually shows aggressive behavior with a high mortality rate. On the other hand, BCC, cSCC, EMPD, and skin adnexal tumors usually show an indolent clinical course and metastasize only rarely. Nevertheless, the metastatic forms of these tumors commonly lead to poor patient outcome. A definitive management strategy for the treatment of advanced NMSC has not been established, mainly due to their rarity and lack of reliable information based on well-controlled randomized trials. Chemotherapeutic regimens for treatment of these diseases have been mainly based on the observations of isolated, small case series or clinical trials with a limited numbers of patients. However, accumulating evidence regarding their pathobiological backgrounds as well as recent advances in molecular biotechnology have facilitated the development of novel drugs for treatment of these diseases. Over the past decade, the U.S. Food and Drug Administration has approved several molecular targeting therapies, including Hedgehog inhibitors for BCC, monoclonal antibodies targeting anti-programmed death ligand-1 and anti- programmed cell death 1 (PD-1) for MCC, and anti-PD-1 for cSCC. Here, we review their clinical utility and discuss updated systemic treatment strategies for advanced NMSC.

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High‐grade trichoblastic carcinoma arising through malignant transformation of trichoblastoma: Immunohistochemical analysis and the expression of p53 and phosphorylated AKT

Cited by 13 publications

References 10 publications

Trichoblastic carcinosarcoma: A case report and literature review

Trichoblastic carcinosarcoma: A case report and literature review

Morphologically high‐grade trichoblastic carcinoma: a clinicopathological study with long‐term clinical follow‐up

Updates on the Systemic Treatment of Advanced Non-melanoma Skin Cancer

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