Malignant proliferating trichilemmal tumour presenting early in life: An uncommon feature

Abstract

Malignant proliferating trichilemmal tumour is a rare cutaneous malignant neoplasm usually occurring in elderly women. We present a case of malignant trichilemmal tumour in a young lady of 26 years of age with a previous history of proliferating trichilemmal tumour at the same site.

Malignant proliferating trichilemmal tumour

“…Saida et al report a patient with multiple TCs which were excised with a wide margin, but later presented with metastases in regional lymph nodes with the same histological findings, suggesting that the original TCs may have been misdiagnosed and were in fact MPTTs 12. Rao et al report a patient with a scalp PTT which was excised but recurred and displayed characteristics of MPTT and so was excised with a 2 cm margin 13. From the few cases in the literature, the treatment of choice seems to be wide local excision and monitoring for recurrence.…”

A large proliferating trichilemmal cyst masquerading as squamous cell carcinoma

“…PTT is usually benign and rarely may undergo malignant transformation in a step-wise manner starting with an adenomatous stage of the trichilemmal cyst to an epitheliomatous stage of the PTT evolving into the carcinomatous stage of the malignant PTT, which is main consideration in the differential diagnosis. [ 6 ] The distinguishing feature of the malignant tumor is the addition of a frankly invasive component that may retain a clear cell pattern with classical trichilemmal keratinization. Nuclear and mitotic activities are variable.…”

Rare Case of Malignant Proliferating Trichilemmal Tumour

“…[5]  It is affecting the scalp of elderly women. [6] It is a large, solitary, multilobulated lesion that may arise within a trichilemmal cyst (Pilar cyst). It yields lobulated and variably exophytic masses that occasionally ulcerate.…”