Multiple pigmented trichoblastomas and syringocystadenoma papilliferum in naevus sebaceous mimicking a malignant melanoma: a clinical dermoscopic-pathological case study

Giorgi, Vincenzo De; Massi, Daniela; Trez, Elisa Gobbato; Alfaioli, Barbara; Carli, Paolo

doi:10.1111/j.1365-2133.2003.05672.x

Cited by 26 publications

(14 citation statements)

References 6 publications

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“…It is well known that multiple tumors may occasionally develop within a pre-existing NS, although the coexistence of three or more tumors is very rare. 1,4,5 Our case was very interesting as, in addition to TB and SCAP, a spindle cell sarcoma was found in association with NS. Mesenchymal tumors associated with NS are very rare.…”

Section: Discussionmentioning

confidence: 80%

Cutaneous leiomyosarcoma, trichoblastoma, and syringocystadenoma papilliferum arising from nevus sebaceus

et al. 2007

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A 54-year-old man presented with a recurrent swelling on the right occipital region of the scalp. Two months earlier, the patient had undergone an initial local excision of the lesion which had enlarged progressively over the previous 2 years on a hairless patch which had been present since birth. On examination, a 5 x 4-cm, pinkish, firm, ulcerated swelling was seen on the right occipital region with a scar running over it. The lesion was not fixed to the underlying bone and there was no regional lymphadenopathy. X-Ray of the skull was normal and no evidence of metastatic disease was identified. Wide local excision of the tumor was performed and it was sent for histopathologic examination. Specimens and slides of the earlier surgery performed elsewhere were also studied. The specimen of the initial surgery consisted of skin-covered tissue with an exophytic firm growth measuring 6 x 5 x 4 cm. The skin surface was rough with areas of ulceration. No necrosis was noted grossly. Microscopically, three distinct lesions were seen. One was a well-circumscribed tumor located in the superficial dermis with lobules of basaloid cell aggregates with peripheral palisading and with no epidermal connection. The lobules were surrounded by cellular fibrous tissue (Fig. 1). Unlike basal cell carcinoma, however, no cleft between the cellular aggregates and stroma was noted. Foci of pigmentation were seen within cellular lobules and these features were consistent with a diagnosis of tricho-blastoma. The second tumor was seen adjacent to the first, and consisted of duct-like structures and cystic spaces with papillary projections. These were lined by double-layered epithelium with stromal infiltration by plasma cells, which are features of syringocystadenoma papilliferum (Fig. 2). The third lesion was a spindle cell sarcoma which formed the major part of the lesion, diffusely infiltrating the dermis and subcutaneous tissue, elevating and ulcerating the overlying skin. The tumor consisted of interlacing fascicles of spindle cells with oval to elongated nuclei having finely dispersed chromatin and inconspicuous nucleoli. The tumor cells were seen encircling the sweat glands, without destroying them (Fig. 3). Nuclear pleomorphism was minimal, with a mitotic rate of 9-10 per high-power field. A small area of epidermal hyperplasia with acanthosis and papillomatosis overlying malformed highly placed sebaceous glands was the only evidence of a pre-existing nevus sebaceus. The status of the surgical margins was not clearly discernible. The wide excision specimen of the recurrent swelling consisted of a skin-covered nodule with ulceration, measuring 3 x 4 x 3 cm, with a gray-white whorled cut surface. No necrosis was noted grossly. Multiple sections showed only spindle cell sarcoma infiltrating the skin and subcutaneous tissue, morphologically similar to the earlier tumor, with ulceration of the overlying skin. The surgical margins were free from tumor. Immunohistochemical stains on the spindle cell sarcoma showed positive staining for smooth...

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Section: Discussionmentioning

confidence: 80%

Cutaneous leiomyosarcoma, trichoblastoma, and syringocystadenoma papilliferum arising from nevus sebaceus

et al. 2007

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“…Hamartomatöz konjenital bir lezyon olan nevus sebaseusun üzerinde selim veya habis çok sayıda tümör gelişebilir ve bunlar içinde en sık olan trikoblastomdur (2, 7). Bu zeminde pigmente tipte trikoblastomlara da rastlanmaktadır (3,8). Kliniğimizde gerçekleştirilen bir çalışmada trikoblastomun nevus sebaseus zemininde gelişen deri tümörleri içinde önemli bir yer tuttuğu saptanmıştır (7).…”

Section: Discussionunclassified

Pigmented Trichoblastoma

Baykal¹,

Yazganoğlu²,

Büyükbabanı³

et al. 2011

Turk J Dermatol

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ÖzetTrikoblastom nadir görülen bir kıl folikülü tümörü olmakla birlikte, nevus sebaseus zemininde gelişen tümörler içinde en sık görülen tümördür. Sağlam deride yerleştiğinde genellikle saçlı deri ve boyunda ortaya çıkan, soliter, asemptomatik, deri renginde, ülsere olmayan papül veya nodül şeklinde görülür. Gerek klinik, gerekse histopatolojik açıdan bazal hücreli karsinom ile karışması nedeniyle önem taşır. Birçok histopatolojik alt tipi tanımlanmış olup, bunlar içinde pigmente trikoblastom nadir rastlananlar arasındadır. Genç erişkin bir kadın hastada saçlı deride öncesinde başka bir lezyon bulunmaksızın, 4 yıl içinde büyüyerek yaklaşık 2 cm'ye ulaşmış, mavimsi siyah renkli nodüler lezyona histopatolojik inceleme ile pigmente trikoblastom tanısı kondu. Trikoblastomun öncü bir lezyon olmaksızın da ortaya çıkabileceğine ve bazen pigmente olabileceğine dikkat çekilmektedir. ( AbstractWhile trichoblastoma is a rare tumor with hair follicles differentiation, it is the most frequent benign tumor developing on nevus sebaceous. It generally appears as a solitary asymptomatic skin-coloured papule or nodule on the scalp and neck. It should be differentiated clinically and histopathologically from basal cell carcinoma. There are various histopathologic subtypes of this adnexal tumour and pigmented trichoblastoma is one of the rarest forms. A young adult female patient presented with a pigmented smooth-surfaced nodule on the scalp, which had enlarged within four years without a preexisting lesion. The histopathological diagnosis was pigmented trichoblastoma. Trichoblastoma may also present without a preexisting nevus sebaceous and may sometimes be of the pigmented type. (Turk J Dermatol 2011; 5: 107-9)

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“…Pigmented trichoblastoma contains melanin depositions but no significant melanocyte hyperplasia 18 .…”

Section: Discussionmentioning

confidence: 99%

Pigmented Trichoblastoma Arising from the Nevus Sebaceous: A Rare Case in Korea

et al. 2009

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Multiple pigmented trichoblastomas and syringocystadenoma papilliferum in naevus sebaceous mimicking a malignant melanoma: a clinical dermoscopic-pathological case study

Cited by 26 publications

References 6 publications

Cutaneous leiomyosarcoma, trichoblastoma, and syringocystadenoma papilliferum arising from nevus sebaceus

Cutaneous leiomyosarcoma, trichoblastoma, and syringocystadenoma papilliferum arising from nevus sebaceus

Pigmented Trichoblastoma

Pigmented Trichoblastoma Arising from the Nevus Sebaceous: A Rare Case in Korea

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