The eyelid is a site of occurrence of desmoplastic trichilemmoma

Eyelid desmoplastic trichilemmoma: 2 case reports and review

Desmoplastic trichilemmomas (DTs) are a rare variant of trichilemmomas first described in 1985. Since then, 11 cases involving the eyelid have been reported. Two cases of this study raise this total to 13. DTs are often clinically confused with basal cell carcinoma and must be proven by biopsy to obtain the correct diagnosis. These lesions are more commonly present in patients older than 50 years. Despite the fact that they are benign, they are often associated with basal cell carcinomas and as such should be managed carefully, requiring excisional biopsy with frozen borders or Mohs controlled margins.

A case of desmoplastic trichilemmoma of the lip treated with Mohs surgery

BACKGROUND

Desmoplastic trichilemmoma is a rare pseudomalignant variant of trichilemmoma. It generally presents as a small papule on the face and is often clinically misdiagnosed as a basal cell carcinoma or verruca vulgaris. It is histologically similar to a trichilemmoma, but has a central area of desmoplasia that can mimic an invasive carcinoma.

OBJECTIVE

The objective was to report a case of desmoplastic trichilemmoma of the lower lip that was treated with Mohs micrographic surgery.

METHODS

A case is reported and the literature is reviewed.

RESULTS

The patient underwent Mohs micrographic surgery for removal of the neoplasm. Six months after the procedure, the patient remained tumor free.

CONCLUSIONS

Although desmoplastic trichilemmoma is a benign neoplasm, it is often histologically confused with basal cell carcinoma and malignant trichilemmoma. Desmoplastic trichilemmoma is also most frequently located on the face. Considering these factors, Mohs micrographic surgery appears to represent an excellent choice for removal of these tumors to achieve clear margins and a good cosmetic result.