Trichoblastic Carcinoma (“Malignant Trichoblastoma”) with Lymphatic and Hematogenous Metastases

Regauer, Sigrid; Beham‐Schmid, Christine; Okcu, Murat; Hartner, E; Mannweiler, Sebastian

doi:10.1038/modpathol.3880118

Cited by 72 publications

(84 citation statements)

References 17 publications

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“…As in our patient, while low-grade TC shows trichoblastoma morphology as well as tumor proliferation in a more infiltrative pattern, undifferentiated carcinoma morphology deriving from trichoblastoma or trichoepithelioma is observed in high-grade TC trichoblastoma (9). Local recurrence, but not distant metastasis, was reported in low-grade TC.…”

Section: Discussionmentioning

confidence: 68%

Rare Case of Trichogenic Tumor: Trichoblastic Carcinoma

Leblebıcı¹,

Özkur²,

Gürel³

et al. 2016

Istanbul Med J

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Adnexal tumors of the hair follicle demonstrate differentiation toward hair follicle structures. Trichoblastic carcinoma is a rare malignant adnexal tumor that is characterized by two distinct forms, low-and high-grade forms, which have been reported in the literature. A 59-year-old man visited our clinic with a 25-year history of an asymptomatic papule in the region of the right temporal fossa. The diagnosis of a low-grade trichoblastic carcinoma was made on the basis of histopathological examination. The history and overall behavior of this tumor remains unknown because of the low incidence rate; therefore, it is important to differentiate it from basal cell carcinoma. We report this case because of its rarity in the literature.Keywords: Trichoblastic carcinoma, trichogenic tumor, basal cell carcinoma IntroductionTrichogenic tumors are derived from embryogenic precursors of hair follicles and are often benign. Trichoblastic carcinoma (TC) is a rare malignant trichogenic tumor (1). Because there are only a few case reports on TC in the literature, its nature remains obscure. A case of low-grade TC is presented here, and the differential diagnosis is discussed. Case ReportA 59-year-old male patient admitted with the complaint of a bulging in the scalp in the right temporal area (Figure 1). The lesion started 25 years ago and grew slowly over time. The patient has a medical history of ulcerative colitis diagnosed 5 years ago for which he used mesalazine 500 mg 2 × 1. On dermatologic examination, an infiltrated, pale pink plaque, 2 cm in diameter, with unclear boundaries was observed, and at the medial edge of this plaque, a hard, irregular, pink papule, 1 cm in diameter, that was elevated by 5 mm, with black pigmentation in the middle, was observed ( Figure 1). No palpable lymphadenopathy was detected on physical examination. A 5 mm punch biopsy specimen was taken from the surface of the papule. A tumor composed of basaloid cell islands forming peripheral palizatic sequencing was detected on histopathological examination of the biopsy specimen. Although the histopathologic findings suggested BCC, due to the mismatch of the clinical characteristics of lesion, the entire lesion was excised by plastic and reconstructive surgery. On histopathological examination, a tumor composed of basaloid cell islands forming palizadic sequencing around settled in the dermis, with no relationship with the epidermis and showing infiltrative growth pattern was found. Necrosis in the midst of some cell islands and significant increase in mitotic figures in the islands where cells with vesicular nuclei resembling supramatriksiyel cells and cells with prominent nuclei and narrow cytoplasm were present. Minimal invasion into the superficial subcutaneous adipose tissue was found. Cell populations reminiscent of the hair follicle bulb could be spotted in some areas. Cellular stroma reminiscent of immature papillary mesenchyme intensifying around the basaloid cell islands was drawing attention. Retraction artifact was not found. Focal duct...

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Section: Discussionmentioning

confidence: 68%

Rare Case of Trichogenic Tumor: Trichoblastic Carcinoma

Leblebıcı¹,

Özkur²,

Gürel³

et al. 2016

Istanbul Med J

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“…Until now, it has not been described after X-ray radiation. It is characterized by a propensity for local recurrence and potential metastatic spread [10,11,12]. This behavior differs substantially from TB or BCC.…”

Section: Discussionmentioning

confidence: 99%

“…A combination of 2 or more patterns within 1 tumor was categorized as mixed TB. The diagnostic of trichoblastic carcinoma (TBC) was considered when tumors showed prominent differentiation towards hair germ and follicular sheath associated with images of ulceration, deep trabecular invasion and asymmetry of architecture, all criteria in favor of malignancy [10, 11]. …”

Section: Methodsmentioning

confidence: 99%

Low-Dose X-Ray Depilatory Treatment Induces Trichoblastic Tumors of the Scalp

Fazaa¹,

Cribier

Zarâa³

et al. 2007

Dermatology

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Background: Depilatory radiotherapy for ringworm was largely used before antifungals were available. Patients who underwent this treatment are at high risk of developing scalp tumors or other cancers. The aim of this study was to characterize scalp tumors occurring after X-ray therapy for ringworm. Methods: We included cases of postradiotherapy scalp tumors recorded at the Dermatology Department of the Charles Nicolle Hospital, Tunis between 1988 and 2001. We recorded clinical descriptions and all cases were resubmitted to microscopic analysis. Results: Sixty-one tumors occurred in 33 men and 12 women with a mean age of 49.8 years. Radiodermatitis was present in 21% of patients. Tumors were basal cell carcinomas in 47 cases, trichoblastomas in 10 cases and trichoblastic carcinomas in 4 cases. Twelve patients had 2–5 tumors, with combinations of tumor types in 3 of them. Mean delay of onset of tumors after radiotherapy was 39.4 years in basal cell carcinoma cases, 38.3 years in trichoblastoma cases and 35.6 years in trichoblastic carcinoma cases. Conclusions: This series shows that although basal cell carcinoma is the most frequent tumor in this situation, trichoblastomas are common. We describe, for the first time, radio-induced trichoblastic carcinomas. Trichoblastic tumors have not yet been described in this context because this concept is relatively recent.

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“…Trichoblastic carcinoma can give nodal and visceral metastases whose prevalence remains unknown [7,8]. In comparison, basal cell carcinoma only metastasizes exceptionally (0.003 to 0.1%) [9].…”

Section: Discussionmentioning

confidence: 99%

Rare Location of a Trichoblastic Carcinoma: A Case Report

Lahbali¹

2017

Austin J Dermatolog

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Trichoblastic carcinoma is a rare malignant adnexal tumor that can give metastases. It occurs mainly in the elderly and often poses diagnostic problems with basal cell carcinoma. We report the observation of a 50-year-old man who consulted for an ulcerated lesion of the abdomen evolving for 1 year. A surgical excision was performed and the histological analysis showed a trichoblastic carcinoma associated with a trichoblastoma. The particularity of our case is the entity which is rare and its location exceptional, since only one case has been reported in the abdominal level in the literature.

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Trichoblastic Carcinoma (“Malignant Trichoblastoma”) with Lymphatic and Hematogenous Metastases

Cited by 72 publications

References 17 publications

Rare Case of Trichogenic Tumor: Trichoblastic Carcinoma

Rare Case of Trichogenic Tumor: Trichoblastic Carcinoma

Low-Dose X-Ray Depilatory Treatment Induces Trichoblastic Tumors of the Scalp

Rare Location of a Trichoblastic Carcinoma: A Case Report

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