Management of 3 Proliferating Pilar Tumors: Definition, Differential Diagnosis, and Treatment Options

Rare Case of Giant Proliferating Trichilemmal Tumor Behind Left Shoulder: A Case Report

Proliferating trichilemmal tumor (PTT) is a rare, benign adnexal tumor of hair follicles that commonly mimics malignancy. Excellent outcomes can be achieved with early surgical excision. Delayed presentations-as in this giant shoulder PTT-are made possible, in part, by patient education and healthcare accessibility in low-resource settings.

Benign proliferating pilar tumor excised with Slow Mohs surgery: A case report

Proliferating pilar tumors are rare, benign, exophytic neoplasms, which can closely resemble a squamous cell carcinoma. We describe a patient with a large benign exophytic tumor on the scalp that had been slowly growing over 10 years. While this class of benign follicular tumors is rare, the standard of care is typically excision with clear histologic margins. In this case, this large scalp tumor was surgically excised with clear margins/permanent section margin control using "Slow Mohs" technique, with subsequent repair using a skin substitute dressing, followed by a delayed skin graft.

Proliferating Pilar Tumors in the Scalp Over a Period of 23 Years in a General Hospital in Mexico City

BACKGROUND

Proliferating pilar tumors are an unusual skin tumor, and they have a cystic component with trichilemmal keratinization and epithelial proliferation. These arise from the outer root sheath of hair follicles. It mainly affects women. The scalp is the most affected area. Diagnosis can be made by biopsy. Surgical excision is the best treatment option.

OBJECTIVE

Report the frequency of proliferating pilar tumors in the scalp in general hospital in Mexico over a period of 23 years.

METHODS

The authors reviewed the database of the dermatopathology service of the General Hospital "Dr Manuel Gea González" from 1999 to August 2022, selecting diagnosticated cases of proliferating pilar tumor, pilar cyst, trichilemmal cyst, or proliferating trichilemmal cyst in the scalp.

RESULTS

The authors discovered 17 cases, 13 were women, the average age was 54.9 years, all the tumors affecting the scalp, and just 3 cases were reported as malignant.

CONCLUSION

In comparison with the existing data, the authors can observe that most of their patients were women and the scalp is the most affected area. Most did not present associated symptoms. As the authors can see, most are benign and long-lasting: however, the authors cannot ignore that a small percentage can be malignant.

Recurrent trichilemmal carcinoma of the periorbital region treated with IMRT radiotherapy: A case report and a review of literature

RATIONALE

Trichilemmal carcinoma (TLC) is a rare malignant cutaneous adnexal tumor usually accept surgery. This report describes an elderly patient with recurrence TLC of the periorbital region after surgery who was subsequently treated with IMRT radiotherapy. After 2-years follow-up visit, there was no progress or metastasis.

INTRODUCTION

TLC is a rare malignant cutaneous adnexal tumor. It usually occurs on sun-exposed areas in elderly people but rarely occurs in the periorbital region. Most cases accept surgery or micrographic Mohs surgery. Recurrence or metastasis of this neoplasm was seldom reported in the medical literature after enough tumor-free margin surgery. And radiotherapy was seldom reported in the treatment for patients of TLC.

PATIENT CONCERNS

Here we report an elderly patient with recurrence TLC of the periorbital region after surgery who was subsequently treated with radiotherapy with a total dose of 66 Gy. Two years later, the patient was admitted head, neck, chest, abdomen CT scan, and no progress or metastasis was detected after 2-years follow-up.

DIAGNOSIS

Trichilemmal carcinoma of the periorbital region.

INTERVENTIONS

We describe the clinical characteristics, pathological features, and choice of examination methods of a patient with TLC in the periorbital region. And we use the radical radiotherapy to treat this case.

OUTCOMES

There are no progress or metastasis after 2-years follow-up.

CONCLUSION

Radiotherapy is a good option for patients with TLC if the patient refuses surgery or fails to achieve a satisfactory tumor-free margin or relapses after surgery.