Trichilemmal Cyst Research Articles

Laryngeal Pilar Cyst Masquerading as an Internal/External Laryngocele.

Objectives:This study aimed to document and describe a case of a laryngeal pilar cyst and to review the literature.Methods:We describe the case of a 65-year-old woman with a laryngeal pilar cyst presenting with occasional ear pain and positional dyspnea, with imaging studies suggesting external/internal laryngocele. We also review the existing clinical literature.Results:Pilar cysts are adnexal skin lesions most commonly found in the scalp of elderly women. They generally have a benign course, but in rare instances single or multiple foci of proliferating cells can lead to the neoplastic formation of proliferating trichilemmal cysts, which carry malignant potential. Depending on the location of the cyst, pilar cysts may also present functional challenges for the patient.Conclusions:Herein, we describe a pilar cyst in and around the larynx appearing initially as a laryngocele. Pilar cysts may present surrounding the larynx and may be mistaken for a vast array of pathologies. It is important to keep the differential broad when evaluating laryngeal masses.

Trichilemmal Cyst Over Scalp: An Uncommon Case Report

We reported a case of a 55-year-old male presented with huge swellings on the scalp. This swelling was presented since adulthood and slowly increases in size to biggest measuring 15 cm × 12 cm. Excision of this swelling was done, and sample were sent for histopathological examination which confirmed this swelling as trichilemmal cyst. No complication was reported in this surgery. The patient was followed up and was doing great.

Cyto-histopathological correlation of skin adnexal tumors: A short series

Background:Skin adnexal neoplasms are relatively rare and thus uncommonly encountered in routine pathology practice.Aims:The present study was conducted with the aim to diagnose various skin adnexal tumors on fine-needle aspiration cytology (FNAC) followed by confirmation on histopathology and immunohistochemistry of the excised tumor.Materials and Methods:A total of 11 cases of superficial nodular swellings of the skin were studied over a period of 2 years from 2015 to 2016. FNAC of the swelling was performed and slides were stained with Giemsa stain. Following FNAC, the swelling was excised and subjected to histopathological examination. Immunohistochemistry was performed in some cases for confirmation.Results:It was observed that overall incidence of adnexal tumors (ATs) encountered on FNAC was very low. Typing of ATs on cytology was possible in 82% cases (9/11 cases) with diagnostic accuracy of 88% (8/9 cases). Most common tumor encountered in the study was nodular hidradenoma followed by pilomatrixoma, trichoepithelioma, cylindroma, chondroid syringoma, and trichilemmal cyst. Majority of the cases were benign except one case, which subsequently turned malignant.Conclusion:FNAC is a simple, safe, and cost-effective tool in diagnosing skin ATs. Cytological diagnosis of these lesions is depends on clinical correlation and cytomorphological features. FNAC in lesions suspected to be malignant can guide the surgeon regarding extent of excision.

Unusual finding in scalp swelling: Microfilaria in fine-needle aspiration and trichilemmal cyst in histopathology

Unusual finding in scalp swelling: Microfilaria in fine-needle aspiration and trichilemmal cyst in histopathology

Profile of Skin Biopsies and Skin Cancer Subtypes in Hail Region : A Three Years Retrospective Study

Objectives: to analyze the spectrum of skin lesions at our institute, and study the age, sex and anatomic distribution pattern. We will also classify the lesions into major categories and determine the incidence of each subcategory. Materials and Methods: we carried a three and half year’s retrospective studyofskin biopsies which were collected from King Khalid Hospital recording system in Hail region in a time period from January 2014 till April 2017.Results: The highest percentage was in the age group 30-39 year (25.1%) with a male preponderance of 52.8%. The head, neck and face were most frequently involved body parts (46.06%). Cysts were the most common (32.3%) which included the sub-types epidermoid cyst, ganglion, dermoid cyst, pilar cyst and brachial cleft cyst. Nevi (19.4%) including intradermal nevus, congenital nevus and blue nevus were the second most common skin lesion. Correlation with the histopathologic diagnosis was positive in 94.9% cases and negative in 5.1% cases.

Proliferating trichilemmal cyst of the scalp: Nine cases and literature review

Proliferating trichilemmal cyst of the scalp: Nine cases and literature review

Clinicopathological study of tumour-like lesions of skin—a study of 238 cases

Tumour-like lesions of the skin are more common than tumours of the skin and this study evaluates their pattern at a tertiary care centre in Maharashtra, India. This aim of this study was to analyse the various tumour-like lesions of the skin and to establish a clinicopathological correlation. All excision specimens received in the histopathology section of the department of pathology from January 2012 to August 2015 that were histopathologically proved to be tumour-like lesions of the skin were included in the study. The data was analysed followed by clinicopathological correlation. A total of 238 cases of tumour-like lesions of the skin were encountered in the present study. Overall, they were most frequent in the fourth decade, in males (57.98%) in the head and neck region (54.62%). Epidermal cyst was the most common tumour-like lesion (69.33%) followed by trichilemmal cyst (15.97%). Epidermal cysts were more commonly found in males in the fourth decade while trichilemmal cysts were more frequent in females with a peak incidence in the seventh decade. Clinically, it is difficult to differentiate tumours of the skin from tumour-like lesions. Histopathological examination is essential for the diagnosis and thus, important for proper management of the patient.

Kyste trichilemmal proliférant malin du scalp : une nouvelle observation

Proliferating trichilemmal cyst (PTC) is a rare adnexal tumor, generally benign, primarily sitting on the scalp of elderly women. About fifty cases are reported in the literature. Herein, we describe another one particularly aggressive. A 70-year-old woman had been showing an increase in the size of an occipital cyst for 6years. A cephalic scan and wide surgical excision had confirmed the diagnosis of a malignant PTC. Four months later, the tumor recurred with regional metastases and intracerebral invasion. Through our case and based on the literature analyzing, we discuss the nosology of PTC and its clinical and histological distinctive elements. Large studies are needed to better understand the specificities of PTC, specially malignant form, but it remains difficult because of its rarity.

Trichilemmal Carcinoma from Proliferating Trichilemmal Cyst on the Posterior Neck.

Trichilemmal cysts are common fluid-filled growths that arise from the isthmus of the hair follicle. They can form rapidly multiplying trichilemmal tumors-, also called proliferating trichilemmal cysts, which are typically benign. Rarely, proliferating trichilemmal cysts can become cancerous. Here we report the case of a patient who experienced this series of changes. The 27-year-old male patient had been observed to have a 1×1 cm cyst 7 years ago. Eight months prior to presentation at our institution, incision and drainage was performed at his local clinic. However, the size of the mass had gradually increased. At our clinic, he presented with a 5×4 cm hard mass that had recurred on the posterior side of his neck. The tumor was removed without safety margin, and the skin defect was covered with a split-thickness skin graft. The pathologic diagnosis was a benign proliferating trichilemmal cyst. The mass recurred after 4months, at which point, a wide excision (1.3-cm safety margin) and split-thickness skin graft were performed. The biopsy revealed a trichilemmal carcinoma arising from a proliferating trichilemmal cyst. This clinical experience suggests that clinicians should consider the possibility of malignant changes when diagnosing and treating trichilemmal cysts.

Dissecting Cellulitis of the Scalp Early Diagnosed by Color Doppler Ultrasound.

Dissecting cellulitis of the scalp (DC) is a chronic inflammatory condition of the scalp that ultimately leads to scarring alopecia. A healthy 19-year-old male presented with a solitary, soft, alopecic nodule that had appeared 1 year before. A color Doppler ultrasound examination showed a hypodermal anechoic fluid collection in the left parietotemporal region of the scalp, connected to the base of widened hair follicles, and presented inner echoes suggestive of debris, as well as several fragments of hair tracts. A diagnosis of DC was made and an epidermal or trichilemmal cyst was ruled out. This case shows the importance of color Doppler ultrasound for supporting the diagnosis at an early stage or with an unusual presentation of DC.

Proliferating trichilemmal tumor of scalp

A proliferating trichilemmal tumor is an uncommon, benign, and well-circumscribed hair follicle tumor. It is also called proliferating pilar cyst of the scalp. The tumor has an unclear pathogenesis, but it is often derived from a pre-existing trichilemmal or pilar cyst and is more common in women. The tumor has a slow-growing nature and capacity to be malignant. A 55-year-old female was admitted to Kars Harakani Hospital Neurosurgery Department with a scalp lesion that was growing for 1 month and was infected. Although scalp lesions are frequently encountered in daily neurosurgical practice, proliferating trichilemmal cysts are quite a rare entity, and neurosurgeons should be aware of trichilemmal tumors during differential diagnosis.

Clinical Characteristics of Benign Pediatric Cranial Vault Tumors: Surgical Considerations Based on 100 Cases

Background/Aims: Tumors of the cranial vault occur at every age of childhood. Although they are mostly benign lesions, their symptomatology is variable and requires extended diagnostics. The choice of therapeutic strategy strongly depends on histopathological diagnosis, and therefore surgical excision is the elective treatment in such cases. Despite several published papers, the literature still lacks reliable clinical characteristics regarding this heterogeneous group of lesions in pediatric patients. Methods: We present a series of 100 children (55 male, 45 female) with scalp and cranial vault masses (average age: 3.6 years; range: 1 month to 17 years). Eighty-three (83%) patients underwent surgical excision. Demographic data, clinical presentation, diagnostic studies, choice of therapy, and the results of treatment were evaluated. Results: All removed tumors were benign pathologies: pilar cysts (30%), epidermoid/dermoid cysts (21%), vascular malformations (11%), inflammatory tumors (5%), and dysraphic remnants (2%). However, underlying bone destruction was observed in 61% of cases. Cranial extension occurred in 34%. Recurrence was noted in 1 case. Conclusions: Cranial vault tumors are characterized by constant growth and may penetrate the cranial cavity. Delayed surgery increases the risk of intracranial complications. Surgical problems include inappropriate planning, higher risk of intraoperative bleeding, and the need for subsequent cranioplasty.

Is Routine Pathologic Evaluation of Sebaceous Cysts Necessary?: A 15-Year Retrospective Review of a Single Institution.

A question arose in our practice of whether all cysts considered sebaceous should be sent for pathologic evaluation. To address this controversial topic, we performed a retrospective study of our single institution's histopathology database. A natural language search of the CoPath database across the institution was undertaken using the diagnosis of sebaceous cyst, epidermal cyst, epidermoid cyst, epithelial cyst, infundibular cyst, pilar cyst, trichilemmal cyst, and steatocystoma. A surgical pathologic review of all specimens with one of these preexcision diagnoses was included in the 15-year retrospective study of 1998 to 2013. All slides were confirmed to have undergone histopathologic review, and the preexcision diagnoses were compared with the postexcision diagnoses. Chart review was undertaken in instances of a diagnosis of malignancy. A total of 13,746 samples were identified. Forty-eight specimens had histopathologic diagnosis of malignancy, for an incidence of 0.3% and with the most common malignancy being squamous cell carcinoma. Chart review showed that for all cases, the surgeons reported uncertainty with regard to the diagnosis because of history or physical characteristics, or both. In addition, a comprehensive literature review showed results consistent with our data and illustrated 19 cases during the past 10 years in which most of the findings were squamous cell carcinoma. We propose the recommendation that routine pathologic evaluation of sebaceous cysts is necessary only when clinical suspicion exists.

An Unusual Presentation of a Breast Lump.

Trichilemmal cyst also known as pilar cyst is a rare cyst arising from the external root sheath of the hair follicle. These cysts are observed on the scalp most commonly in females. The occurrence of trichilemmal cysts in areas other than the scalp is extremely rare. We report a case of an 80-year-old female with trichilemmal cyst of the breast which was first misdiagnosed as a sebaceous cyst because of the unusual disease site and our unfamiliarity with the disease. The patient underwent excision of cyst along with the cyst wall and histopathological diagnosis was trichilemmal cyst of the breast. A review of literature shows that trichilemmal cyst of the breast is an extremely rare condition which accounts for 0.1% of the skin biopies reported till to date. We report a case of trichilemmal cyst of the breast with relevant discussion on trichilemmal cysts.

Twinkle artefact in the ultrasound diagnosis of superficial epidermoid cysts.

The aim of the study was to evaluate whether the twinkle artefact is a valuable feature in the sonographic diagnosis of superficial epidermoid cysts. A retrospective search was undertaken of our institution's Radiology Information System and pathology database to identify cases of superficial masses showing the twinkle artefact that proceeded to surgical excision. Eighteen superficial masses demonstrating the twinkle artefact were identified that were submitted for pathological analysis. Of these, 17 were confirmed to represent epidermoid cysts and only 1 case had an alternative diagnosis (proliferating trichilemmal cyst). The presence of the twinkle artefact appears to be a specific and valuable ancillary sonographic feature for the diagnosis of superficial epidermoid cysts.

Malignant Proliferating Trichilemmal Tumour of the Scalp with Intra-Cranial Extension and Lung Metastasis-a Case Report.

Malignant proliferating trichilemmal tumour (MPTT) is a rare cutaneous tumour predominantly affecting the scalp, eyelids, neck and face of elderly women. It is a large, solitary, multilobulated lesion that may arise within a pilar cyst. These tumours are largely benign, often cystic and are characterized by trichilemmal keratinisation. However at times, the tumour has an aggressive clinical course and a propensity for distant metastasis. We report a case of a 29-year-old male who presented with a scalp swelling. Histology revealed malignant proliferating trichilemmal tumour of scalp. CT thorax showed multiple nodules in both lungs suggestive of lung metastasis. The patient underwent palliative radiotherapy and chemotherapy and expired 2months after palliation. To the best of our knowledge, malignant proliferating trichilemmal tumour of the scalp with intra-cranial extension and lung metastasis is a rare condition, and only a handful of cases are reported till date. We report a case of malignant proliferating trichilemmal tumour of the scalp with intra-cranial extension and lung metastasis with relevant discussion at the same time.

Multiple Giant Pilar Cyst Distributed Over the Body Since Childhood.

Trichilemmal cyst or pilar cyst is defined as a cyst containing keratin and its breakdown products. It is usually situated on the scalp with a wall resembling external hair root sheath. In this case report we present a 55-year-old man with multiple giant pilar cysts that were distributed over the whole body since childhood. One of the cyst on the chest was transformed to squamous cell carcinoma (SCC).

A rare case of intraoral trichilemmal cyst

Trichilemmal cysts, also known as pilar cysts, are slow-growing lesions commonly found on the scalp of elderly women. They arise from outer root sheath epithelium and have a distinctive pattern of keratinization called trichilemmal keratinization. Here, we describe a rare case of a trichilemmal cyst on the lower lip mucosa of a 29-year-old man. The infrequency of intraoral hairs unquestionably results in the shortage of reported cases of trichilemmal cysts into the oral cavity.

Histological Study of Nodular Outgrowths of the skin in Patients from a tertiary care Hospital, Hyderabad

Background: Pathological studies have documented the extent of spread of various skin lesions and have made significant contribution to the understanding of etiology and pathogenesis; Pathologic studies have played an important role in the diagnosis of various skin lesions. Objective: To study of Nodular Outgrowths of the skin in Patients from a tertiary care Hospital, Hyderabad. Methods: Histopathological study of benign nodular lesions of the skin, studied during the period of October 2010-September 2012 at Department of Pathology, Owaisi Hospital and Research Centre and Princess Esra Hospital. Skin biopsies were received from the Outpatient department of Dermatology. For this study, Clinico-pathologic details were recorded. During this period a total of 67 cases of benign nodular skin disease were studied. The patients were selected, irrespective of age, sex, socioeconomic status and residence. Cases were taken up for study after appropriate consent. All the skin biopsies either Punch or Incisional, were stained with Hematoxylin & Eosin, and examined. Special stains like AFB, PAS etc. were done in required cases. Results: Maximum number of cases was seen in the age group of 31-50 years. Male to female ratio was 1.16:1 showed male preponderance. Out of 23, syringoma were found in 9 (39.13%), trichoepithelioma in (26.08%), syringocystandenoma papilliferum in 4 (17.39%), sebaceous adenoma in 3 (13.04%), and pilar cyst in 1 (4.34%). Females (65.21%) outnumbered males (34.78%) in our study population. Conclusion: The present study has emphasized the role of histopathologic examination in cutaneous disorders and disease. Key words: Nodular Outgrowths, Histopathological study, Cutaneous disorders

Epidermoid cyst: a case report and review of literature

Epidermoid cysts are quite rare in the head and neck region. They present as an asymptomatic swelling. The differential diagnosis of these lesions include dermoid cyst, milia, pilar cyst, etc. Although benign they need to be treated as soon as a possible as they can cause disfigurement of the head and neck region. We report a case of epidermoid cyst in the middle face region which was surgically treated.