Tricholemmal carcinoma:

Abstract

Tricholemmal carcinoma (TLC) is a cutaneous adnexal tumor with presumed external hair sheath differentiation. In order to better understand the salient features of this neoplasm, we analyzed the histologic and clinical findings in 10 cases of TLC. Eight patients were males, and two were female; they ranged in age from 55-88 years. Each tumor occurred in hair bearing, sun-exposed skin, and involved the scalp, face, trunk, or upper extremities. The lesions were usually slightly raised, pale tan or reddish, and keratotic; were usually present for less than 1 year; and measured 0.4-2.0 cm. All of them were treated by wide local excision; neither recurrence nor metastasis was reported after 11 to 92 months of clinical followup. Histologically, each TLC was composed of a lobular proliferation centered on the pilar apparatus. Cells with glycogen-rich, mucin-negative, clear or pale eosinophilic cytoplasm predominated. Brisk mitotic activity (4-39 mitoses per 10 high power fields) was typical. Involvement of the interfollicular epidermis was invariably noted, with superficial ulceration in seven tumors. Transitional zones between TLC and the adjacent epidermis were not seen, although pagetoid spread occurred in two examples. Invasion of reticular dermis was present in eight cases, with infiltration to mid-dermis in five TLC. All tumors exhibited areas of tricholemmal type keratinization; dyskeratotic cells were noted in six examples. Hyperkeratosis and parakeratosis were variably present as well. Actinic damage was a constant feature. Despite local invasion at diagnosis, the clinical course of TLC was indolent in all cases.

Recurrent and Metastatic Trichilemmal Carcinoma of the Skin Over the Thigh: A Case Report

“…Although the histological features suggest an intermediate to high grade malignancy, TC usually has an indolent clinical course (1). Recurrence or metastasis of this neoplasm has seldom been reported in the medical literature (10)(11)(12). Surgery is considered the treatment of choice for TC and periodic surveillance without adjuvant therapy is generally sufficient (4).…”

A Case of Trichilemmal Carcinoma Treated with Mohs Micrographic Surgery

“…According to Wong and Suster, in the outcomes of 13 patients with wide excision, neither recurrence nor metastasis was found 5 . Mohs micrographic surgery has some advantages including high cure rate, smaller defect size, low recurrence rate and immediate reconstruction 9 . Billingsley, Lai, and Garrett performed Mohs micrographic surgery because of the histologically malignant feature of this tumor, although clinically, metastasis and recurrence are rare (Table 1) 7, 18,19 .…”

Carcinoma triquilemal: relato de um caso

“…Even though its histological structure suggests a certain malignancy grade, trichilemmal carcinoma has an indolent clinical course. Cases with recurrence or metastasis have been seldom reported in the literature [7][8][9] . Trichilemmal carcinomas must be distinguished from other malignant skin lesions so that the best treatment options can be adopted according to the lesion.…”