Malignant proliferating trichilemmal tumor of the scalp masquerading as squamous cell carcinoma: A need for common awareness

Tikku, Gargi; Jain, Dhruv; Grover, Rajesh K.

doi:10.4103/0377-4929.142705

Cited by 5 publications

(3 citation statements)

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“…However, the absence of a precancerous epidermal lesion such as actinic keratosis suggests the diagnosis of malignant KTP. The immunohistochemical study would confirm the diagnosis while revealing the absence of expression of AE13 and AE14 monoclonal antibodies [4,5]. The management of the malignant trichilemmal cyst remains essentially surgical and relies on surgical excision with generally a lateral margin of 1 cm.…”

Section: Discussionmentioning

confidence: 99%

Rare Evolution of a Trichilemmal Cyst: A New Observation of Carcinomatous Degeneration

Youssef¹

2023

J Otolaryngol Res & Rep

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The trichilemmal cyst, also called the hair cyst, is an infrequent adnexal tumor that derives from the isthmic portion of the hair follicle. It is an oftensolitary tumor with preferential localization of the scalp. Its evolution is generally benign. Malignant cases are very rare and sometimes aggressive. Only about fifty cases are reported in the literature. We report a new observation of carcinomatous degeneration illustrating the difficulty of the therapeutic management of this aggressive form. It was a 55-year-old patient with no significant pathological antecedents who, since 2012, has had voluminous and numerous scalp swelling, slow and indolent evolution. The management was surgical with excision of 13 cysts initially. Pathological examination showed an appearance consistent with proliferative trichilemma cysts without evidence of malignancy. The patient had a recurrence of cystic lesions after five years. She was reoperated with excision of three cysts whose histopathological examination showed a well-differentiated keratinizing squamous cell carcinoma developed on one of the cysts. We decided on a surgical revision with extensive excision of the tumor followed by recovery by a sliding flap and rotation. The evolution was favorable with a follow-up of two years. The main take away of our case is the locally aggressive character of this malignant form which necessitate an extensive surgical excision, thus posing the problem of reconstruction.

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Section: Discussionmentioning

confidence: 99%

Rare Evolution of a Trichilemmal Cyst: A New Observation of Carcinomatous Degeneration

Youssef¹

2023

J Otolaryngol Res & Rep

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“…Giant cutaneous trichilemmal horns consist of a mixture of squamous epithelial cells and trichilemmal keratinized debris, mitoses can be common but not in the atypical form (29). PTTs are often confused histologically with metastatic or invasive SCC, as both can display keratinocytic nuclear atypia and infiltrative growth (30). On pathology, MPTTs are distinguished from SCC by trichilemmal keratinization involving an abrupt transition of nucleated to anucleated keratinized epithelium without granular layer.…”

Section: Discussionmentioning

confidence: 99%

Malignant proliferating trichilemmal tumor: a rare neoplasm in a rarer location. Case report and review of the literature

Montella¹,

Farabini²,

Lucà³

et al. 2022

Ann Res Oncol

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“…Interestingly, in human medicine, variants of tumors arising from squamous epithelium or resembling SCC have been described in the skull. They include adenosquamous carcinoma and benign and malignant proliferating trichilemmal tumors in addition to SCC [7,13,28,29]. Their differentiation is based on careful microscopic analysis and is sometimes also supported by immunohistochemistry [28].…”

Section: Discussionmentioning

confidence: 99%

Aggressive squamous cell carcinoma of the cranium of a dog

Łojszczyk-Szczepaniak

Łopuszyński

Szadkowski

et al. 2021

BMC Vet Res

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Background The authors report a case of keratinized squamous cell carcinoma (SCC) in a 14-year-old dog with extensive cranial bone invasion. To our knowledge, this is the first description of such a case of cranial keratinized SCC with aggressive generalized osteolysis described in a dog. Case presentation The 14-year-old dog was referred for radiological examination with suspicion of head trauma with clinical signs of head deformation, exophthalmos and nasal discharge. The skull radiographs showed a large osteolytic defect of the frontal bone and parietal bone in the region of the external sagittal crest. Findings from the skull CT scan included generalized osteolysis in the region of parietal bone, frontal bones, maxilla on the right side and the nasal bone including the dorsal nasal concha. In the area of bone loss, new soft tissue formation with multifocal foci of mineralization was visible. The ultrasound examination revealed hypoechogenic changes with hyperechoic foci consistent with mineralization and poor vascularization. The brain and ocular structures were without visible changes. Fine needle aspiration cytology (FNAC) was performed, and squamous cell carcinoma was suspected. After 3 months, the re-presented to the clinic. The dog became progressively listless, his appetite was decreased, and he became acutely blind. Follow-up skull CT scan revealed significant osteolysis, which affected a significant aspect of the cranium. All bone defects had been replaced by new 3.5 cm-thick soft tissue formations with multifocal small 1–2 mm areas of mineralization. There was no evidence of metastasis. Histological examination confirmed the suspicion of squamous cell carcinoma. Conclusions This paper is the first report of cranial SCC in a dog causing extensive bone osteolysis. The lesions in this dog originated from the frontal and parietal bones including frontal sinuses. There are variants of tumors that arise from squamous epithelium or resemble SCC in the skull. These examples include adenosquamous carcinoma and proliferating trichilemmal tumours. In addition, there is possible malignant transformation caused by papilloma viruses. In the veterinary literature, there is only one similar description of adenosquamous carcinoma in a cat with similar clinical manifestations. It is justified to suspect a process of neoplastic epithelial origin in all cases of aggressive and extensive skull bone lysis. This issue should be subject to further investigation.

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Malignant proliferating trichilemmal tumor of the scalp masquerading as squamous cell carcinoma: A need for common awareness

Cited by 5 publications

References 0 publications

Rare Evolution of a Trichilemmal Cyst: A New Observation of Carcinomatous Degeneration

Rare Evolution of a Trichilemmal Cyst: A New Observation of Carcinomatous Degeneration

Malignant proliferating trichilemmal tumor: a rare neoplasm in a rarer location. Case report and review of the literature

Aggressive squamous cell carcinoma of the cranium of a dog

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