Multiple proliferating trichilemmal cysts of the skalp: a case report. Multiple proliferating pilar tumors of the scalp

Abstract

Proliferating trichilemmal cyst, also known as proliferating pilar scalp tumor, is a rare benign tumor of the hair follicle. While trichilemmal cysts are common intradermal or subcutaneous cysts, occuring in 5-10% of the population, only 2% will develop into proliferative trichilemmal cyst. The differential diagnosis should include lesions such as malignant proliferating trichilemmal tumor and squamous cell carcinoma. Surgical treatment is the only effective method for treating these rare cysts. We present a case report of a 78-years-old female patient who has entered the Neurosurgery clinic of "St. Marina" University Hospital with clinical manifestation of rapidly growing from several months subcutaneous formation on the head and the presence of two smaller ones. MRI scan discovered three subcutaneous tumor formations suspicious for trichilem cysts, one of which was gigantic in size. After clinical discussion, under general anesthesia an operative treatment was performed with total extirpation of the cysts. Postoperatively, surgery-related complications were not observed. The patient was mobilized and verticalized on the day after intervention and discharged on the 5th day. As a result, a good cosmetic effect was obtained. Proliferating trichilemmal cyst is an uncommon neoplasm, and reporting of these lesions are important due to the good clinical evolution compared to the malignant macroscopic and microscopic feature of these tumor formations.