Proliferating Trichilemmal Tumor Research Articles

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.

Advanced treatment of giant proliferating trichilemmal tumor: Limited resection combined with neoadjuvant ALA-PDT

Wide local excision with a 1 cm margin is the standard treatment for proliferating trichilemmal tumor (PTT), but it is challenging to treat giant tumors, or tumors located on the scalp and face. We present a case of a 90-year-old woman with painful PTT on the cheek who was cured by a combination of limited resection and neoadjuvant ALA-PDT. Preoperative and postoperative 20 % ALA-PDT was used for a total of 6 sessions. PTT was resected 2 mm outside the clinical margins under local infiltration anesthesia. The PTT with a size of 69 × 59 × 37 mm was removed by limited resection. ALA-PDT was an effective therapy for local anti-inflammation and anti-tumor. The old woman received it well and recovered quickly. Limited resection combined with neoadjuvant ALA-PDT is an advanced treatment for giant PTT, which has the advantages of minimally invasive, effective and safe.

Prevention of recurrence in malignant proliferating trichilemmal tumor of scalp in young female using adjuvant radiation therapy after surgery

Background: Proliferating trichilemmal tumors (PTTs) are rare benign neoplasms that arise from the outer sheath of a hair follicle. Group III PTTs are high-grade malignant tumors reported to exhibit a high recurrence rate, lymph nodes, and a tendency to develop distant metastasis. Case Presentation: A 25 years old female patient was presented to us with a history of recurring soft tissue scalp lesions. The lesion recurred three times within 1 year. There was no history of trauma. Every time the lesion was excised but no histopathology of the specimen was done. Upon the third recurrence, it came out to be a malignant proliferating trichilemmal tumor (MPTT). Considering the young age of the patient and keeping in view the history of multiple recurrences with positive deep margin even after the third surgery, the patient was planned external beam radiotherapy (RT) 50 Gy/25 fx to scalp with 9 Mev electron using 0.5 cm bolus. The post-RT follow-up currently of 2 years is uneventful. Conclusion: The mainstay of treatment is surgery with wide surgical margins as local recurrence is most common in MPTT. Adjuvant RT was used in this case to prevent recurrence.

Proliferating Trichilemmal Tumor at the Nianankoro Hospital in Ségou: About A Case

Proliferating trichilemmal tumor (PTT) is an uncommon lesion that typically occurs on the scalp of older women. The risk factors which have been incriminated in the appearance of tumors of the scalp are: chronic sun exposure, the presence of sebaceous nevi, a history of ionizing radiation, burns, trauma or surgery of the scalp. CT can confirm the cystic and tissue nature of the lesion with the presence of calcifications, signs of locoregional invasion. The diagnosis of certainty is based on the anatomopathological study. The principle of treatment of TTP without the metastasis is a wide surgical excision with a margin of 1 cm in normal tissue. Endocranial extension and distant metastases are obstacles to surgical treatment. We report a rare case of scalp tumors in a hospital setting in a 75-year-old woman.

Malignant proliferating trichilemmal tumor of thigh: a case report of an unusual location of a rare cutaneous adnexal tumor

Proliferating trichilemmal tumour (PTT) is a well-circumscribed dermal or subcutaneous neoplasm with squamoid cytologic features and trichilemmal-type of keratinization. Usually, proliferating trichilemmal cysts are benign, although rarely, can undergo malignant transformation, at which point they are referred to as malignant proliferating trichilemmal tumours (MPTTs). Ninety percent of PTTs occur on the scalp, but they have also been found on the forehead, nose, back, chest, abdomen, buttocks, elbow, wrist, mons pubis and vulva. Here a case of an 89-year-old woman with a malignant proliferating trichilemmal tumour of right thigh is discussed, which is a very rare site for occurrence of the same.

Proliferating Trichilemmal Tumor: A Case Study

Proliferating trichilemmal tumor (PTT) is a scarce tumor of exterior root sheath that appears to grow within the wall of a pre-existing pilar cyst in most cases. This report presents a case of malignant PTT in the posterior sacrum of a 33-year-old man presenting with limited mobility and a history of paraplegia.

MALIGNANT PROLIFERATING TRICHILEMMAL TUMOR ONE CASE AND LITERATURE REVIEW

Proliferating trichilemmal tumors (PTTs) are uncommon lesions. PTT is thought to originate from the trichilemmal cyst (TC) and have the potential for malignant transformation, at which point it is termed a malignant proliferating trichilemmal tumor (MPTT). we report an observation of a 55-year-old lady patient presenting with a malignant proliferative trichilemmal tumor, emphasizing the aggressive, rapidly extensible and metastatic character. MPTTare aggressive tumors with a bad prognosis, the treatment of which is based on surgery with margins of 1 cm, lymph node dissection in the event of lymph node involvement and radio-chemotherapy.

Proliferating Pilar Tumor: Two Cases and a Review of the Literature

Trichilemmal cysts (TCs) are the most common cystic lesions arising on the scalp and up to 2% give rise to a proliferating trichilemmal tumor (PTT). A rare subset of PTTs are termed malignant due to their histologic characteristics, aggressive behavior and potential for metastasis. The histological hallmark of TCs and PTTs is the absence of a granular layer resulting in abrupt trichilemmal keritanization.

Malignant Proliferating Trichilemmal Tumor of the Scalp

Malignant proliferating trichilemmal tumor (PTT) is a rare adnexal tumor with follicular differentiation. It mainly occurs in the scalp region of elderly females. It is a solitary, large ulceroproliferative lesion that can have an aggressive clinical course with metastases. Clinically and histologically, it is a close mimicker of squamous cell carcinoma. We report a middle-aged female who came with sudden enlargement of a longstanding nodular scalp lesion in the left parietal region. Incisional biopsy revealed a malignant PTT of the scalp. She underwent wide local excision of the mass and is doing well without any evidence of recurrence after 5 months of follow-up.

An Unusual Presentation of Proliferating Trichilemmal Tumor Developing in Psoriatic Plaque: A Case Report

Proliferating trichilemmal tumor (PTT) is a rare, mostly benign neoplasm which stems from the follicular outer root sheath epithelium. PTT occurs as a subcutaneous cystic nodule slowly enlarging to a larger noduler mass, and is usually localized on the scalp of elderly women. To the best of our knowledge, PTT localized on a psoriatic plaque has not been reported previously. Herein, we report an unusual case of benign PTT arising from a psoriatic plaque on the knee of a 63-year-old male patient. Keywords: proliferating trichilemmal tumor, psoriasis, trichilemmal cyst

Cranial vault tumor: malignant proliferating trichilemmal tumor of the scalp

Proliferating trichilemmal tumor (PTT) is a rare cutaneous tumor that mainly occurs in the scalp, eyelids, neck, and face of elderly women. In most cases, it is a unique, large, multi-lobulated, cystic lesion originating from a hair follicle. These tumors are mostly benign and are characterized by trichilemmal keratinization. However, in rare cases, they may be aggressive with a propensityfor distant metastasis.We report the case of a 69-year-old male patient, who presentedwith as welling on his forehead that had rapidly increased in size over the past year. CT scan and magnetic resonance imaging (MRI) showed a tumor located on the cranial vault, associatedwith an intracranial extension. Chest X-ray and CT scan found a tumor in the right lung. The patient underwent surgery for the removal of the tumor. The histological examination confirmedthe diagnosis of malignant PTT (MPTT). To the best of our knowledge, only a few cases of MPTT have been published. Furthermore, only one case of MPTT of the scalp with endocranial extension and lung metastasis has been eported to date.Through this case, we discuss the prognostic factors and the management of this aggressive lesion.

A large helmet-shaped proliferating trichilemmal tumor of the scalp: Is definitive radiotherapy the treatment? A case report

BackgroundBenign proliferating trichilemmal tumors (PTTs) are a rare entity that arises from the outer root sheath of a hair follicle. They range from a benign PTT that recurs locally to the more aggressive malignant PTT that, in addition to recurring locally, has the potential for metastatic spread. However, as a group, PTTs are slow growing and amenable to surgery. To the best of our knowledge, radical radiotherapy without surgery has been used in only one case in an elderly male patient with good oncological and cosmetic results.Case presentationWe present a case of a young unmarried female with a disfiguring PTT of the scalp not amenable to surgery treated successfully with radiotherapy providing good cosmesis. Volumetric modulated arc therapy was used to treat this patient with a dose of 50 Gy in 25 fractions over 5 weeks. A theoretical risk of malignant transformation was explained to the patient. The patient has maintained good cosmesis over the last 12 months with no signs of re-growth.ConclusionIn patients with PTT not amenable to surgery, radiotherapy may be an effective alternative providing local control and good cosmesis.

Proliferating Trichilemmal Tumor of the Auricula: A Very Rare Locus.

Proliferating trichilemmal tumor (PTT) is a rare but morphologically characteristic tumor, derived from the external root sheath. They are commonly localized as a solitary lesion on the scalp. They rarely occur in other regions. PTTs generally behave in a benign fashion, up to 20% of the lesions may undergo malignant transformation into squamous carcinoma. We present an elderly woman with a cystic swelling on the crus of auricular helix diagnosed as PTT. To our knowledge, this is the first case in the English literature, of PTT of the auricula.

Atypical Proliferating Trichilemmal Cyst with Malignant Breast Skin Transformation: A Case Report and Review of the Literature.

Proliferating trichilemmal tumors (PTTs) are benign adnexal skin neoplasms that arise from the outer root sheath of the hair follicle. These tumors are most commonly observed on the scalp and occur, most of the time, in elderly women. Malignant transformation of these neoplasms is a rare event; less than 50 cases have been reported in the English medical literature. We present the case of a 39-year-old Hispanic woman with a tumor located on the skin of one of her breasts that in her third surgical procedure the histologic examination revealed the presence of a malignant proliferating trichilemmal tumor (MPTT). Furthermore, a review of the medical literature and a discussion of the clinical and pathologic features of this rare entity are provided.

Malignant proliferating trichilemmal tumor of the scalp with secondary infection in an elderly man

A 65-year-old man presented with the complaints of a growth on the scalp, which ruptured spontaneously leading to bleeding and foul smelling discharge associated with severe pain. Examination revealed ulceroproliferative growth with slough and surrounding induration, infested with maggots. Histopathological examination revealed proliferating trichilemmal tumor (PTT) with secondary infection. Wide excision of the tumor was done with 1 cm margin all around it. PTT is a benign neoplasm that can rarely undergo malignant transformation thought to originate from trichilemmal cyst. Malignant PTT (MPTT) predominantly affects the scalp, eyelids, neck, and face and the treatment recommended being a wide local excision.

Proliferating Trichilemmal Tumor of the Gluteal Region of a Young Man with Spontaneous Regression

We describe a case of a proliferating trichilemmal tumor (PTT) on the gluteal region of a 24-year-old male, presenting as a solitary nodule with spontaneous regression. This is the first report of a case in PTT with spontaneous regression.

A Rare Cutaneous Adnexal Tumor: Malignant Proliferating Trichilemmal Tumor.

Proliferating trichilemmal tumors (PTTs) are neoplasms derived from the outer root sheath of the hair follicle. These tumors, which commonly affect the scalp of elderly women, rarely demonstrate malignant transformation. Although invasion of the tumors into neighboring tissues and being accompanied with anaplasia and necrosis are accepted as findings of malignancy, histological features may not always be sufficient to identify these tumors. The clinical behavior of the tumor may be incompatible with its histological characteristics. Squamous-cell carcinoma should certainly be considered in differential diagnosis because of its similarity in morphological appearance with PTT. Immunostaining for CD34, P53, and Ki-67 is a useful adjuvant diagnostic method that can be used in differential diagnosis aside from morphological findings. In this study, we aimed to present the case of a 52-year-old female patient with clinicopathological features. We reported a low-grade malignant proliferating trichilemmal tumor in this patient and detected no relapse or metastasis in a 24-month period of follow-up.

Squamous Cell Carcinoma of the Scalp Masquerading as Trichilemmal Tumor of the Scalp

ABSTRACT Background Adnexal components tumors of the skin are very rare and are seen as benign lesions of the scalp in aged women. Trichilemmal tumor is usually benign and rarely under-goes malignant transformation in a stepwise manner starting with an adenomatous stage of the trichilemmal cyst to an epitheliomatous stage of the proliferating trichilemmal tumor (PTT) evolving into the carcinomatous stage of the malignant proliferating trichilemmal tumor (MPTT). Case report A 53-year-old woman reported with huge swelling in the posterior region of the scalp. The swelling was mobile and soft to firm in consistency not fixed to the skull bone. The surface was smooth and getting under the swelling was not possible, needle biopsy reported as trichilemmal tumor. Contrast enhanced computed tomography (CECT) neck did not show any nodes in the neck, especially the posterior compartment. The tumor was widely excised with 1 cm margin and the periosteum was kept intact with split skin graft. An area of periosteal adher ence to the tumor seen was excised. The histopathology report on serial sectioning reported grade 1 moderately differentiated squamous cell carcinoma (SCC). Postoperative external beam radiotherapy of 66 Gy was given. The patient is being followed up and no recurrence is seen. Conclusion Malignant transformation in a proliferating trichilemmal tumor a rare entity and should be differentiated from SCC and the better prognostic trichilemmal carcinoma. A protocolbased adjuvant therapy is available for squamous cell carcinoma but not for trichilemmal carcinoma (TLC) and MPTT. A major meta-analysis may help to establish a clinical outcome-based classification and management protocol for these tumors. How to cite this article Nanjundappa A, Halkud R, Venugopal B, Chavan P, Sidappa KT, Biswas S, Samskruthi M, Naik SM. Squamous Cell Carcinoma of the Scalp Masquerading as Trichi-lemmal Tumor of the Scalp. Int J Head Neck Surg 2014;5(3):144-147.

Giant trichilemmal cyst on gluteal region

Proliferating trichilemmal tumor (PTT) is typically seen in middle aged or elderly patients, with a strong predilection for women and is usually situated in scalp. We are reporting such a tumor located on the gluteal region of a 52-year-old male. The tumor was diagnosed as PTT based on its specific histological features. The case is unusual because of sex of the patient and the tumor location. Moreover, this report illustrates a rare tumor which can be diagnostically challenging. The differentiation between a benign or malignant process in these lesions can sometimes be difficult. Careful clinical and histological assessment is necessary for an accurate diagnosis.

Scalp Reconstruction after Resection of a Large Recurred Proliferating Trichilemmal Tumor Using an Anterolateral Thigh Free Flap

Proliferating trichilemmal tumor (PTT) is an uncommon lesion that is characterized by an exuberant growth of cells derived from the external root sheath of the hair follicle. Histologically, it presents as trichilemmal keratinization. It is known to be derived from trichilemmal cysts and to have a potential for malignant conversion. In the latter case, it is called malignant proliferating trichilemmal tumor [[1]]. As it has some low-grade malignant potential as well as unpredictable biological behavior, wide excision with a 1 cm margin of normal tissue is required in order to prevent recurrence.