I n t r o d u c t i o nTrichilemmal carcinoma (TC) is a rare malignant tumor that develops from the external root sheath of the hair follicle. It usually is found in the skin of the face or ears of elderly women on areas that are exposed to the sun, and TC generally has an indolent clinical course (1,2). This condition is usually curable after a wide excision (2). TC must be differentiated from other skin abnormalities such as squamous cell carcinoma, basal cell carcinoma, keratoacanthoma, and invasive Bowen's disease (3-5). TC is a low-grade carcinoma with a low metastatic potential (6). Surgical excision is considered to be the first choice for curative treatment (7,8), and no other reliable treatment strategies for TC have yet been established (9).We report here on a case of metastatic TC involving the skin over the thigh and this was treated with cisplatin and cyclophosphamide combination chemotherapy.
C a s e R e p o r tA 63-year-old woman presented with a mass lesion in the left thigh in September 2006. The medical history and family history were unremarkable. The lesion was 5×5×4 cm in size, with irregular margins and superficial erosion. The entire lesion was removed by performing wide surgical excision and the resection margin was free of tumor. The final diagnosis was TC, and the tumor was composed of several epithelial aggregations arranged in various growth patterns, including solid, lobular and trabecular patterns (Fig. 1). In addition, the skin biopsy revealed that the specimen included neoplastic cells with abundant, clear cytoplasm, and the cells showed prominent atypia and high mitotic activity (Fig. 2).Two years later, the patient was hospitalized with swelling of the left lower leg and enlargement of the left inguinal lymph nodes. The blood pressure was 140/90 mmHg, the pulse rate was 78 bpm, the Trichilemmal carcinoma (TC) is an uncommon cutaneous neoplasm that develops from the external root sheath of the hair follicle. It is considered to be a low-grade carcinoma with low metastatic potential. Local recurrence and metastasis are rare after surgical excision. We report here on a case of metastatic TC in the skin over the thigh, and this tumor was treated with cisplatin and cyclophosphamide combination chemotherapy.