Trichilemmal Cyst Research Articles

Trichilemmal cyst with xeroderma pigmentosum in pediatric patient – A case report with review of the literature

Trichilemmal cyst with xeroderma pigmentosum in pediatric patient – A case report with review of the literature

Rare presentation of pilomatrixoma as a fungating breast mass: Case report and literature review

Pilomatrixomas are rare tumors arising from the cellular matrix of hair follicles and typically manifest as subcutaneous nodules. This case report highlights a rarer presentation in a 68-year-old female who presented with a protruding, painful left breast mass. After an initial biopsy revealed a benign pilar cyst with keratin material, the tumor exhibited progressive growth, resulting in skin fistulas and calcified material exuding from the skin. Final surgical pathology confirmed a benign pilomatrixoma. This case underscores the importance of timely diagnosis and surgical treatment of this rare tumor to prevent tumor growth, skin erosion, and secondary infection.

MRI findings of preauricular sinus: a case report

BackgroundThe preauricular sinus (PS) is a benign congenital abnormality affecting the soft tissues in the preauricular region. Diagnosis is typically clinical and routine imaging is usually unnecessary in symptomatic cases, but individuals with recurrent sinuses or previous unsuccessful surgeries may benefit from pre-operative imaging. Furthermore, PS may be detected incidentally during head and neck magnetic resonance imaging (MRI), emphasizing the need for radiologists and ear, nose, and throat specialists to be familiar with its characteristics. Notably, there is a gap in the existing literature regarding the MRI description of PS.Case presentationWe present the case of a 19 year-old man complaining of pain in the right external auditory canal. During the physical examination, a small depression was observed at the front edge of the ascending limb of the helix with the discharge of particulate material. Suspecting a PS, further investigation through an MRI examination was requested. The contrast-enhanced MRI documented a PS characterized by a small superficial subcutaneous cyst located in front of the right external auditory canal at the front edge of the ascending limb of the helix, behind the superficial temporal artery, and behind and above the parotid gland. The cyst showed restricted diffusivity (due to purulent content) and was surrounded by inhomogeneous adipose tissue with contrast-enhancement (due to inflammatory phenomena).ConclusionsTo the best of our knowledge, there is a lack of clear description of MRI semeiotics of PS in the literature and this case helps to fill that gap. MRI could play a role in the pre-surgical planning of complex PS cases. Additionally, a comprehensive understanding of the MRI appearance is essential for distinguishing PS from other diseases, such as branchial fistulas, epidermal inclusion cysts, and trichilemmal cysts.

Use of Rubber Bands to Improve the Surgical Field in Patients With Multiple Trichilemmal Cysts.

Use of Rubber Bands to Improve the Surgical Field in Patients With Multiple Trichilemmal Cysts.

Sole Surprises—An Atypical Encounter with Pilar Cyst in the Foot: A Case Report

Sole Surprises—An Atypical Encounter with Pilar Cyst in the Foot: A Case Report

304 Scar Assessment of Elliptical Versus Punch Biopsy Excision for Epidermoid and Pilar Cysts

304 Scar Assessment of Elliptical Versus Punch Biopsy Excision for Epidermoid and Pilar Cysts

TRICHILEMMAL CYST OF THE SCALP: A CASE REPORT

Trichilemmal cysts are dermal epithelial cysts that develop at the expense of the hair follicle. Histologically, they are characterized by the presence of trichilemmal keratinization, defined by the absence of the granular layer usually present between the spinous and horny layers. A 48 years old female had found a scalp lump for 15 years, the lump gradually increased. Physical examination found 2 protruding lesions. Surgical excision was performed and histopathological examination of the specimen confirmed a trichilemmal cyst. The wound healed well after resection with no recurrence after one year follow up.

Malignant pilar cyst in a young woman: Case report and literature review

The patient was a young, 30-year-old woman presenting with a long standing painless scalp lesion with six month history of recent increase in size with associated pain. Clinically the swelling had benign features, therefore excisional biopsy was done. However histology revealed malignant pilar cyst.

Malignant proliferating trichilemmal tumor post-chemotherapy: A case report

The malignant proliferating trichilemmal tumor (MPTT) is an exceptional adnexal neoplasm of the skin, primarily observed in the scalp of elderly women, often precipitated by local trauma or chronic inflammation. Notably, MPTT exhibits a propensity for local aggressiveness, frequently leading to diagnostic challenges reminiscent of squamous cell carcinoma. The primary treatment modality entails surgical excision with adequate margins, yielding a relatively low local recurrence rate. Herein, we present the case of a 50-year-old woman diagnosed with MPTT of the scalp several years subsequent to undergoing chemotherapy for breast cancer, initially misdiagnosed as squamous cell carcinoma upon biopsy. This case marks only the third reported instance associating MPTT with chemotherapy following breast cancer treatment. We aim to draw attention to this particularly aggressive tumor and its potential origination from benign trichilemmal cysts due to chemotherapy.

A Rare Case of Proliferating Trichilemmal Tumor Treated with Radiotherapy

Proliferating Trichilemmal Tumor (PTT) is a rare tumor of the outer root sheath of the hair follicle with different biological behavior. They usually develop in older patients, most commonly affecting women, from pre-existing pilar cyst. Histologically, this tumor may mimic squamous cell carcinoma (SCC). The standard of treatment is surgical excision with a margin of normal tissue. As most of the patients are not good surgical candidates, Radiotherapy plays an important role in the management of this tumor. We report a case of PTT on the occipital region of a 79-year-old female with its brief overview. In view of large size of the lesion and advanced age of the patient, Neoadjuvant Radiotherapy was planned and delivered. A near complete response of the lesion to radiotherapy was observed with good cosmesis. We discuss the role of radiotherapy in the management of PTT in various settings with literature review. Keywords: Proliferating Trichilemmal Tumor, Proliferating Pilar Tumor, Radical Radiotherapy, Neoadjuvant radiotherapy, outer root sheath tumor, skin cancer, scalp tumor, cosmesis.

Trichilemmal Cyst Mimicking Dermatofibroma on the Lower Back: An Atypical Presentation at an Atypical Site

Trichilemmal Cyst Mimicking Dermatofibroma on the Lower Back: An Atypical Presentation at an Atypical Site

Line-field confocal optical coherence tomography of eyelid margin growths: A case series.

The clinical differential diagnosis of lesions arising on the eyelid margin may be challenging and an unneeded surgical approach may have serious functional and aesthetic consequences. Nonetheless, early recognition and treatment of malignant tumors of the eyelid margin is mandatory. Line-field confocal optical coherence tomography (LC-OCT) is a novel tool for the in vivo, real-time skin imaging. The aim of the study was to identify and analyze the LC-OCT features of a series of eyelid margin growths and to correlate these features with the histopathological findings. Patients with eyelid margin growths who were scheduled for lesion excision underwent LC-OCT examination. Inclusion criteria were a challenging clinical aspect of the lesions and a clinical history of recent onset (up to 12 months). In all cases, the histopathological examination of the excised lesions was performed for the final diagnosis. A total of 31 lesions located on the upper (13 cases) or lower (18 cases) eyelid margin from 28 consecutive patients (male=15, female=13; mean age: 64.7 years, range: 44-87 years) were evaluated and excised. The histopathologic diagnoses were nodular basal cell carcinoma (BCC) (nine cases), squamous cell carcinoma (SCC) (three cases), compound nevus (four cases), dermal nevus (two cases), seborrheic keratosis (four cases), pyogenic granuloma (one case), trichilemmal cyst (three cases), and hidrocystoma (five cases). LC-OCT allowed the in vivo recognition of the main microscopic features of the examined lesions. LC-OCT represents a promising tool for the evaluation of eyelid margin lesions. Advantages of non-invasive diagnosis particularly relevant in such a sensitive region include a more correct planning of the treatment and, in case of surgery, the most appropriate surgical approach and, importantly, a correct timing of intervention.

Case of Malignant Proliferating Trichilemmal Tumour in Gluteal Region

Malignant Proliferating Trichilemmal Tumour (MPTT) is a rare, malignant cutaneous adnexal tumour that originates from the outer root sheath cells of the isthmus of hair follicles. This article aims to report a rare case of a high-grade malignant trichilemmal tumour arising in the context of a proliferating Trichilemmal Cyst (TC) in a 65-year-old female who presented with a painless swelling in the left gluteal region that had been present for two months. There have been only about 100 cases reported so far. Both the clinical features and the imaging findings were suggestive of an ostensibly benign lesion. As a result, the cyst was excised; however, further histopathological evaluation revealed an unexpected case of rare MPTT. Consequently, a timely second revision surgery was performed to ensure tumour-free margins. This case illustrates that the diagnosis of MPTT is highly challenging. Without prior knowledge and a high index of suspicion, the diagnosis of MPTT could easily be missed. MPTT is often misdiagnosed as a variant of Squamous Cell Carcinoma (SCC). The subtle nuances of the unique histopathological pattern of MPTT can help differentiate it from SCC.

RECURRENCE OF TRICHILEMMAL CYSTS ON THE SCALP: A CASE REPORT

Background: Trichilemmal cysts, benign lesions originating from the outer root sheath of hair follicles, commonly present as asymptomatic nodules on the scalp. Despite their typically non-threatening nature, cases of recurrence and familial clustering underscore the need for a comprehensive understanding of their clinical course and potential genetic influences. Case Presentation: We present a 44-year-old male with a lifelong history of trichilemmal cysts who sought surgical intervention due to discomfort caused by cyst formation on the scalp. Over a 15-year period, three cysts were surgically removed, with one inadvertently missing, leading to its progressive enlargement and the emergence of new cysts over the subsequent eight years. Magnetic resonance imaging revealed multiple well-defined cystic lesions with distinct margins, consistent with trichilemmal cysts. A second surgical procedure successfully excised all cysts, confirming the diagnosis through histopathological examination. Conclusion: The presented case highlights the challenges in managing recurrent trichilemmal cysts and emphasizes the importance of comprehensive surgical intervention. The benign nature of the lesions was reaffirmed through negative histopathological findings for dysplasia or malignancy. The family history of similar cystic formations raises intriguing questions about potential genetic predispositions and shared environmental factors. This case contributes valuable insights into the clinical dynamics of trichilemmal cysts and prompts further exploration into their genetic underpinnings.

Optical coherence tomography for the diagnosis and differentiation of cutaneous cysts: acase series

Cutaneous cystic lesions (n = 35) were examined with optical coherence tomography. Cysts were visible as ahyporeflective roundish area with aclear margin; in some cases, the epidermis was thinned. Epidermal cysts, trichilemmal cysts, and hidrocystomas had alinear margin representing the epithelium of the cyst, whereas mucoid pseudocysts showed no linear margin. Trichilemmal and epidermal cysts presented with hyperreflective content that corresponds to keratin. By visualizing the margin and the content of the cyst, it was possible to differentiate between different types of cysts.

WITHDRAWN: Pediatric case of trichilemmal cyst arising on the face

WITHDRAWN: Pediatric case of trichilemmal cyst arising on the face

A case report of a head full of trichilemmal cysts

Trichilemmal cysts are considered the most common form of cutaneous cysts in the scalp, most often in middle-aged females. They can be solitary or multiple, gradually increasing in size and number, but it is unusual to find very large numbers of cysts. We describe here the case of a 53-year-old woman who presented with multiple trichilemmal cysts, along with a squamous cell carcinoma. Surgical removal was performed and the diagnosis was confirmed on histological examination. The clinical features of trichilemmal cysts are relatively straightforward; however, the histological confirmation is always necessary to confirm the diagnosis and discard other differential diagnosis.

Malignant proliferating trichilemmal tumor in male: A rare case entity with diagnostic dilemma

Abstract Trichilemmal tumor is a rare hair follicle tumor that is, thought to occur from a malignant transformation of a benign trichilemmoma. The tumor develops from the outer root sheath of the hair follicle. The patient underwent a wide local excision with 1 cm clear margin. The defect was covered by split thick skin graft harvested from ipsilateral thigh after consulting the plastic surgery department. Trichilemmal cyst can be misdiagnosed as other cutaneous lesions. Like in our case, initial FNAC was suggestive of a epidermoid cyst but post excision Histopathological examination gave us the real picture of a trichilemmal tumor. Recurrent tumors are very rare and can get misdiagnosed as squamous cell carcinoma. Malignant proliferating trichilemmal tumors are rare cutaneous tumors that are very rare in males. These tumors can be misdiagnosed as squamous cell carcinoma and require external stimuli for malignant conversion from benign counterparts. Wide local excision is sufficient for treatment.

Malignant appearance of trichilemmal cyst: a case report with review of the literature

69 years old male presented with one month history of non-tender, nodular, pinkish left neck swelling, measuring 10×20 mm. CECT revealed left neck dermatofibrosarcoma protuberans with submandibular vascular malformation. Surgical wide local excision of the lesion and split skin graft was done. Histopathology confirmed trichilemmal cyst (TC). TC is adnexal lesions, found in hair bearing areas. Pinkus pointed out that TC are keratin-filled cysts with a wall resembling the external root sheath of hair follicle. 2% can develop into proliferating trichilemmal tumours (PTTs) and malignant proliferating trichilemmal tumours (MPTTs). PTTs were originally described by Jones as benign but locally aggressive skin neoplasms. Female to male preponderance of 6% to 1%, with average age of 65 years at presentation. 90% are located on the scalp, while the residual 10% occur mainly on the back but they can develop any part of the body such as submandibular region. Proliferating TCs present as lobulated masses, soft in consistency. The masses may become exophytic, ulceration and may show malignant transformation. On imaging, these lesions can be either cystic or solid mass. Histopathological, it is characterised by absence of intercellular bridges between epithelial cells lining the cyst wall. Cyst cavity contains amorphous eosinophilic keratin. Satyaprakash et al report, complete surgical excision is warranted for TCs as if there is proliferative or malignant potential, it would affect the postoperative management and overall prognosis. TC, locally aggressive skin neoplasms and rarely, occurrence at submandibular region or become malignant and appropriately managed to prevent recurrence.

Benign Cutaneous Cysts: A Comprehensive Analysis of 1160 cases.

Background Cysts are common skin abnormalities that are mostly benign; however, sometimes malignant lesions may present clinically as cystic manifestations. Benign cutaneous cysts can be of different morphological types and their diagnosis relies on histological evaluations. The most common mode of treatment is surgical excision, whichis curative. Methodology This is a retrospective cross-sectional study conducted at the Department of Histopathology, Chughtai Institute of Pathology, Lahore, Pakistan from 1st January 2020 to 31st December 2022. Non-probability consecutive sampling was done, and all the cases of benign cutaneous cysts were included. All cases were microscopically reviewed by two histopathologists, and variables like age, gender, site of the lesion, and histological diagnosis were noted. The data were analyzed using IBMSPSSStatistics for Windows, Version 29 (Released 2022; IBM Corp., Armonk, New York, United States). Results A total of 1160 recorded cases of benign cutaneous cysts were included. Overall gender distribution revealed males (n=489, 42.1%) and females (n=671, 57.8%). The age range was 3 to 91 years with a mean age of 37.56 ± 16.05 years.The three most common cysts were epidermal inclusion cysts (74.3%), trichilemmal cysts (15.1%), and dermoid cysts (6.3%). Other cysts were uncommon includinghidrocystoma (1.9%), steatocystoma (0.3%), verrucous cysts (0.3%), comedones (0.6%), hybrid cysts (0.2%), milia (0.3%), and vellus hair cysts (0.2%). The most common site was back (23.5%) for epidermal inclusion cysts, scalp (74.4%) for trichilemmal cysts, and eye (33.8%) for dermoid cysts. Conclusion Benign cutaneous cysts have a broad morphological spectrum with a wide age range. Epidermal inclusion cysts, trichilemmal cysts, dermoid cysts, and hidrocystoma account for the four most common types. For each of the other cyst type, the prevalence was under 1%. Female gender predominated in epidermal inclusion cysts, trichilemmal cysts, and dermoid cysts while male gender was common in other cysts. Overall majority of the cysts presented in the head and neck area.