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Lee DY, Han KM, Yoon JS. A malignant proliferating trichilemmal cyst arising on the elbow of a man: A case report and review of the literature. Medicine (Baltimore) 2023; 102:e34035. [PMID: 37352060 PMCID: PMC10289708 DOI: 10.1097/md.0000000000034035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 05/26/2023] [Accepted: 05/29/2023] [Indexed: 06/25/2023] Open
Abstract
INTRODUCTION Trichilemmal cysts (TCs) are common benign cysts that form from the hair follicles in the skin. Proliferating trichilemmal cysts (PTCs) are rare types of TCs characterized by rapid cellular proliferation. Malignant transformation of PTC (MPTC) is a rare adnexal tumor that account for <0.1% of all skin cancers. TCs and PTCs are benign tumors; however, MPTCs grow rapidly and are prone to metastasis. CASE PRESENTATION A 77-year-old man was referred to our hospital with a solitary pinkish mass on his left elbow. Trichilemmal carcinoma arising from a PTC was confirmed through excisional biopsy, and wide excision was performed. One month postoperatively, a cystic mass was observed and was suspected to have local recurrence; however, bursitis was confirmed after excisional biopsy. After 1 year of follow-up, the patient maintained an improvement without recurrence or any other surgical complications. CONCLUSIONS In addition to being a very rare disease, MTPC occurred in the elbow of a man who does not fit the general etiology; therefore, it is considered an interesting case, and we report this case for academic contribution.
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Affiliation(s)
- Dong Yun Lee
- Department of Plastic and Reconstructive Surgery, DongGuk University Medical Center, Seoul, South Korea
| | - Kang Min Han
- Department of Plastic and Reconstructive Surgery, DongGuk University Medical Center, Seoul, South Korea
| | - Jung Soo Yoon
- Department of Plastic and Reconstructive Surgery, DongGuk University Medical Center, Seoul, South Korea
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Fischer GM, Lindeman NI, Ligon AH, Russell-Goldman E. Proliferating Pilar Tumors Are Characterized by Recurrent 15q, 6q, and 6p22.2 Alterations. Am J Dermatopathol 2023; 45:217-226. [PMID: 36346171 DOI: 10.1097/dad.0000000000002308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
ABSTRACT Proliferating pilar tumors (PPTs) are rare neoplasms of external root sheath derivation, which most commonly occur on the scalp of elderly women. Although typically showing classic histologic features such as trichilemmal type keratinization, a lobular architecture and peripheral palisading, squamous cell carcinoma (SCC) remains a common diagnostic pitfall. Therefore, we sought to explore the molecular pathogenesis of PPTs and compare it with that of cutaneous squamous cell carcinoma (cSCC). Herein, we describe the use of a next-generation DNA sequencing platform to provide the most comprehensive molecular genetic analysis to date of a cohort of 5 PPTs and compare them to 5 head and neck cutaneous SCCs. Recurrent broad arm-level gains of 15q and concurrent single-copy losses of 6q and 6p22.2 were observed in 4 of 5 (80%) PPT cases. Other recurrent mutations or alterations of significance were not found in PPTs. Notably, these chromosomal changes were not identified in any of the 5 cutaneous SCCs, which instead showed recurrent alterations in the known SCC driver genes TP53 , CDKN2A , and NOTCH1 . Here, we show for the first time that PPTs are molecularly distinct from cutaneous SCC and provide evidence that recurrent alterations in chromosome 15 and chromosome 6 are central to the pathogenesis of PPTs.
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Affiliation(s)
- Grant M Fischer
- Department of Pathology, Brigham and Women's Hospital, Boston, MA
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TP53 Abnormalities and MMR Preservation in 5 Cases of Proliferating Trichilemmal Tumours. Dermatopathology (Basel) 2021; 8:147-158. [PMID: 34070291 PMCID: PMC8161811 DOI: 10.3390/dermatopathology8020021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 05/19/2021] [Accepted: 05/22/2021] [Indexed: 01/02/2023] Open
Abstract
Proliferating trichilemmal tumours (PTT) are defined by a benign squamous cell proliferation inside a trichilemmal cystic (TC) cavity. A possible explanation of this proliferative phenomenon within the cyst may be molecular alterations in genes associated to cell proliferation, which can be induced by ultraviolet radiation. Among other genes, alterations on TP53 and DNA mismatch repair proteins (MMR) may be involved in the cellular proliferation observed in PTT. Based on this assumption, but also taking into account the close relationship between the sebaceous ducts and the external root sheath where TC develop, a MMR, a p53 expression assessment and a TP53 study were performed in a series of 5 PTT cases, including a giant one. We failed to demonstrate a MMR disorder on studied PTT, but we agree with previous results suggesting increased p53 expression in these tumours, particularly in proliferative areas. TP53 alteration was confirmed with FISH technique, demonstrating TP53 deletion in most cells.
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Yildiz P, Aydin Ulgen O, Yol C, Demirkesen C. Proliferating Pilar Tumors: Can Immunohistochemistry Differentiate Benign and Malignant Forms? Am J Dermatopathol 2021; 43:198-201. [PMID: 33405401 DOI: 10.1097/dad.0000000000001743] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Proliferating pilar tumor (PPT) is an adnexal tumor of purported differentiation toward the follicular outer root sheath. Immunohistochemistry has been suggested to differentiate between benign and malignant forms. METHODS Eleven benign (PPT) and 9 malignant PPT lesions were reviewed; Ki67, p27, and p53 were applied. The staining intensity (strong, moderate, weak, and negative), positive cell numbers, and marker indexes (%) were scored using image-analysis software (ViraSoft). RESULTS Overall, there was no significant correlation between Ki67 and p53 and histopathological features. However, malignant PPTs had significantly lower numbers of p27-positive cells (P = 0.030). CONCLUSIONS Our study includes the largest group of patients in whom image analysis of p53, Ki67, and p27 has been used to try to separate benign from malignant lesions. Although there were no significant differences regarding Ki67 and p53, malignant lesions have a statistically lower expression of p27. Further studies may be needed to determine the clinical usefulness of image analysis in this differential diagnosis.
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Affiliation(s)
- Pelin Yildiz
- Department of Pathology, Bezmialem Vakif University, Medical Faculty, Istanbul, Turkey
| | - Ovgu Aydin Ulgen
- Department of Pathology, Istanbul University, Cerrahpasa Medical Faculty, Istanbul, Turkey ; and
| | - Cansu Yol
- Department of Pathology, Istanbul University, Cerrahpasa Medical Faculty, Istanbul, Turkey ; and
| | - Cuyan Demirkesen
- Department of Pathology, Acibadem University, School of Medicine, Istanbul, Turkey
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Frouin E. Cas n°4 : tumeurs épithéliales cutanées. Ann Pathol 2020; 40:366-370. [DOI: 10.1016/j.annpat.2020.06.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 06/10/2020] [Indexed: 10/24/2022]
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Lindsey SF, Aickara D, Price A, Pavlis J, Wei EX, Elgart G, Cho-Vega JH. Giant proliferating trichilemmal cyst arising from a nevus sebaceus growing for 30 years. J Cutan Pathol 2017; 44:639-642. [PMID: 28419495 DOI: 10.1111/cup.12951] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Revised: 04/06/2017] [Accepted: 04/08/2017] [Indexed: 12/28/2022]
Abstract
Nevus sebaceus of Jadassohn, a congenital cutaneous hamartoma, has the potential to develop into various epidermal adnexal-origin neoplasms. While the most common neoplasms are trichoblastoma or syringocystadenoma, proliferating trichilemmal cysts are exceptionally rare. We report a case of a 63-year-old Cuban male with a giant proliferating trichilemmal cyst arising from a nevus sebaceus on the right shoulder which had been growing for 30 years. Proliferating trichilemmal cysts arising from nevus sebaceus cases are difficult to diagnose clinically and histologically as they are very rare and have not been defined by exact diagnostic criteria. Our case creates awareness of this particular tumor in nevus sebaceus and shares clinical and histological diagnostic information that can be used to make a proper diagnosis.
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Affiliation(s)
- Scott F Lindsey
- Department of Dermatology, Miller School of Medicine, University of Miami, Miami, Florida
| | - Divya Aickara
- College of Medicine, Florida State University, Tallahassee, Florida
| | - Alexandra Price
- Department of Dermatology, Miller School of Medicine, University of Miami, Miami, Florida
| | - Janelle Pavlis
- Department of Dermatology, Miller School of Medicine, University of Miami, Miami, Florida
| | - Erin X Wei
- Department of Dermatology, Brigham and Women's Hospital, Harvard Medical School, Miami, Florida
| | - George Elgart
- Department of Dermatology, Miller School of Medicine, University of Miami, Miami, Florida
| | - Jeong Hee Cho-Vega
- Department of Pathology, Dermatopathology Division, Sylvester Comprehensive Cancer Center and Miller School of Medicine, University of Miami, Miami, Florida
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Rangel-Gamboa L, Reyes-Castro M, Dominguez-Cherit J, Vega-Memije E. Proliferating trichilemmal cyst: the value of ki67 immunostaining. Int J Trichology 2014; 5:115-7. [PMID: 24574687 PMCID: PMC3927166 DOI: 10.4103/0974-7753.125599] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background: A proliferating trichilemmal cyst (PTC) is an uncommon, rapidly-reproducing cutaneous epithelial cyst, differentiating from the isthmic portion of the outer hair root sheath. It is usually described as a benign tumor, but malignant transformation has been reported and is then denominated as a malignant proliferating trichilemmal tumor. Ki67 immunostaining has been used as a methodology for the evaluation of tumor grade in other tumors, due to its distinctive reaction patterns which exclusively involve proliferating cells. Objectives: (1) To report the incidence of cases of PTCs in a General Hospital during a 12 years period. (2) To determine the expression of ki67 using immunohistochemical staining. (3) To correlate ki67 reaction patterns with clinical prognosis. Materials and Methods: The dermatology department's files during a period of 12 years were reviewed; cases with a diagnosis of PTC were selected, and ki67 immunostaining was done when enough biological material was available. Results: A total of 15 cases with a diagnosis of PTC were identified. In 12 cases, ki67 immunostaining was carried out. In 9 of the 12 cases, ki67 was observed in the basal cells of the cystic epithelium, one case was moderately positive in palisading epithelial cells; in the other two cases ki67 immunostaining was negative. Clinical follow-up was done and revealed that no patient had local recurrence in 5 years after surgical removal of PTC. We therefore consider this immunostaining technique is probably correlated with low recurrence potential.
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Affiliation(s)
- Lucia Rangel-Gamboa
- Division of Investigation, General Hospital "Dr. Manuel Gea González", Calz. Tlalpan 4800, Seccion VX, C.P 14000, México
| | - Magdalena Reyes-Castro
- Department of Pathology, General Hospital "Dr. Manuel Gea González", Calz. Tlalpan 4800, Seccion VX, C.P 14000, México
| | - Judith Dominguez-Cherit
- Department of Dermatology, INCMN "Salvador Zubirán", Vasco de Quiroga 15, Sección XVI, 14000, Mexico City, México
| | - Elisa Vega-Memije
- Division of Investigation, General Hospital "Dr. Manuel Gea González", Calz. Tlalpan 4800, Seccion VX, C.P 14000, México
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Tola EN, Elezoglu B, Dellal FD. Simple vulval trichilemmal cyst. J OBSTET GYNAECOL 2013; 33:320-1. [PMID: 23550877 DOI: 10.3109/01443615.2012.755502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- E N Tola
- Department of Obstetrics and Gynecology, Agri Government Hospital, Agri, Turkey
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El Hassani Y, Beaulieu JY, Tschanz E, Marcheix PS. [Proliferating trichilemmal tumor of the pulp of a finger: case report and review of the literature]. ACTA ACUST UNITED AC 2013; 32:117-9. [PMID: 23490214 DOI: 10.1016/j.main.2013.02.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2012] [Revised: 10/17/2012] [Accepted: 02/04/2013] [Indexed: 11/18/2022]
Abstract
Trichilemmal cyst is a benign tumor, developed from hair follicle, located mainly at the scalp. We report a clinical case of unusual location at the finger pulp confirmed by histology. The main differential diagnosis in this reported case was a whitlow. The origin of this cyst is probably the nail matrix whose keratinization is trichilemmal. Surgical excision biopsy allowed a good clinical outcome.
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Affiliation(s)
- Y El Hassani
- Service de chirurgie de la main, hôpital universitaire de Genève, rue Gabrielle-Perret-Gentil 4, 1211 Genève 14, Suisse
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Gulati HK, Deshmukh SD, Anand M, Morale V, Pande DP, Jadhav SE. Low-grade malignant proliferating pilar tumor simulating a squamous-cell carcinoma in an elderly female: a case report and immunohistochemical study. Int J Trichology 2012; 3:98-101. [PMID: 22223970 PMCID: PMC3250030 DOI: 10.4103/0974-7753.90818] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
A 65-year-old lady presented with an ulcerated lesion over the occipital region of nine-year duration, an incisional biopsy of which was reported as squamous-cell carcinoma. A wide local excision was performed and the tissue was sent for histopathological examination which revealed a low-grade malignant pilar tumor. Focal invasion and atypia were noted. Immunohistochemical (IHC) analysis revealed positivity for CD34 and calretinin immunomarkers favoring outer root sheath origin. Ki67 immunostains revealed a relatively low immunoreactivity indicating the low-grade nature of the tumor; however, p53 immunostain showed strong diffuse nuclear staining confirming the malignant nature of the tumor. Proliferating pilartumors (PPT) are rare tumors and less than 100 well-documented cases of malignant PPT have been reported so far in the literature. These tumors have been recently classified into benign, low- and high-grade malignant tumors and statistically significant difference was found in their biological behavior. However, we propose that IHC can be of immense value in assisting the subtyping of the tumor, so that the behavior and role of adjuvant therapy can be validated in future studies.
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Affiliation(s)
- Harveen Kaur Gulati
- Department of Pathology, Smt. Kashibai Navale Medical College & General Hospital, Narhe, Pune, Maharashtra, India.
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Talghini S, Halimi M, Baybordi H. Expression of P27, Ki67 and P53 in squamous cell carcinoma, actinic keratosis and Bowen disease. Pak J Biol Sci 2009; 12:929-933. [PMID: 19777788 DOI: 10.3923/pjbs.2009.929.933] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
This study aims at evaluating the expression of P27, Ki67 and P53 in Squamous Cell Carcinoma (SCC), Actinic Keratosis (AK) and Bowen Disease (BD) specimens. In an analytic-descriptive setting, skin biopsy specimens of 45 patients were evaluated in three 15-case groups including BD, AK and SCC specimens. Fifteen normal skin biopsy specimens were obtained and used as the control group. Immunohistochemical staining was performed in all the specimens and the expression rates and patterns of Ki67, P27 and P53 were determined. The results were compared between the four groups. Ki67 was expressed in 0.8, 23.7, 12.3 and 19.3% of the cells in the normal skin, AK, BD and SCC groups, respectively. No significant difference was seen between the three pathological conditions regarding the expression rate of Ki67. P27 was positive in 23.4, 26.2, 25.9 and 4.5% of specimens in the normal skin, AK, BD and SCC groups, respectively. This rate was significantly the lowest in the SCC group. P53 expression was detected in 26.6, 41.8 and 54.6% of the assessed cells in the AK, BD and SCC groups, respectively. There was no expression of P53 in the normal skin specimens. This rate was significantly the highest again in the SCC group. Based on these results, the quantitative and qualitative (pattern of distribution) evaluation of the expressions of Ki67, P27 and P53 may be helpful in differentiating malignant and premalignant epidermal lesions, particularly in unsatisfactory or fragmented specimens.
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Affiliation(s)
- S Talghini
- Department of Pathology, Sina Hospital, Ward of Pathology, Tabriz University of Medical Sciences, Tabriz, Iran
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Abstract
PURPOSE Cell cycle progression is regulated by interactions of specific cyclins and cyclin dependent kinases (CDKs) at the G1-S and G2-M checkpoints and cell cycle deregulation plays a major role in carcinogenesis of human cancers. PATIENTS AND METHODS To investigate the role of cell cycle regulators in the pathogenesis and progression of human gastric cancers, 23 cases of gastric carcinomas were examined for the expression of cyclin B1, p34cdc2, p27(Kip1) and p53 by immunohistochemical methods, and gene expression was correlated with various clinicopathologic findings. RESULTS Out of 23 cases studied, cyclin B1 was diffusely expressed in 20 cases (87.0%), p34cdc2 in 14 cases (60.9%) and p53 in 12 cases (52.2%), whereas in normal gastric tissues, cyclin B1 and p34cdc2 were weakly expressed and p53 was not expressed. In contrast, p27(Kip1) was expressed in only 8.7% of gastric carcinomas compared with 78.3% of normal gastric tissues. There was correlation between the expression of cyclin B1 and expression of p34cdc2 (p=0.002), between the expression of cyclin B1 and loss of p27(Kip1) (p=0.025), and between the expression of p34cdc2 and loss of p27(Kip1) (p=0.065). In addition, expression of cyclin B1 was correlated with regional lymph node metastasis (p=0.032). CONCLUSION Our results indicate that cyclin B1 and p34cdc2 are involved in the genesis or progression of gastric cancers. Furthermore, overexpression of cyclin B1 may play an important role in lymph node metastatic potential of gastric cancer. Thus, abnormal expression of cyclin B1 and CDKs, overexpression of p53 and loss of p27(Kip1) expression may play important roles in human gastric carcinogenesis.
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Affiliation(s)
- Dong-Hoon Kim
- Department of Pathology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 108 Pyung-dong, Jongro-gu, Seoul 110-746, Korea.
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Tierney E, Ochoa MT, Rudkin G, Soriano TT. Mohs' Micrographic Surgery of a Proliferating Trichilemmal Tumor in a Young Black Man. Dermatol Surg 2006; 31:359-63. [PMID: 15841643 DOI: 10.1111/j.1524-4725.2005.31090] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Proliferating trichilemmal tumor is an uncommon tumor of the follicular isthmus of the hair follicle. It usually presents as a solitary nodule on the scalp of older white women. Although these lesions typically behave in a benign fashion, recurrences and metastasis after local excision have been reported. Mohs' micrographic surgery has been effectively used to treat adnexal neoplasms. OBJECTIVE To report a case of a proliferating trichilemmal tumor in a young black man, which was excised using Mohs' micrographic surgery. METHODS Case report and review of the literature. RESULTS Mohs' micrographic surgery demonstrated an irregular extension of the tumor beyond a 1 cm surgical margin. CONCLUSIONS Proliferating trichilemmal tumors should be considered in the differential diagnosis of cutaneous neoplasms on the scalp in persons of any age (with the possible exception of infants and children), sex, or race. Mohs' micrographic surgery may be considered an optimal treatment option for proliferating trichilemmal tumors because these lesions may have an infiltrative component that may not be clinically apparent.
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Affiliation(s)
- Emily Tierney
- Division of Dermatology, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
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Karaca S, Kulac M, Dilek FH, Polat C, Yilmaz S. Giant proliferating trichilemmal tumor of the gluteal region. Dermatol Surg 2005; 31:1734-6. [PMID: 16336902 DOI: 10.2310/6350.2005.31323] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND Proliferating trichilemmal tumors are rare cutaneous neoplasms that show features of typical pilar cysts but also show extensive epithelial proliferation, variable cytologic atypia, and mitotic activity. Proliferating trichilemmal tumors are benign lesions; however, there are numerous reports of malignant proliferating trichilemmal tumors. OBJECTIVE We present a case of benign proliferating trichilemmal tumor of an 81-year-old woman that was located on the left superior gluteal region for 30 years. METHODS A tumor measuring 9 x 7 cm was surgically excised with a 1 cm conservative margin of normal tissue. RESULTS Based on the histopathologic findings of tumor, this case was diagnosed as proliferating trichilemmal tumor. The patient's condition was successfully treated with total excision. CONCLUSIONS Our case is an unusual presentation of proliferating trichilemmal tumor. Physicians should be aware of this entity while differentiating cutaneous tumor located on the gluteal region.
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Cesinaro AM, Migaldi M, Corrado S, Maiorana A. Expression of p27kip1 in basal cell carcinomas and trichoepitheliomas. Am J Dermatopathol 2002; 24:313-8. [PMID: 12142610 DOI: 10.1097/00000372-200208000-00005] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Immunohistochemical analysis was used to evaluate p27kip1 expression in normal hair follicles and in a series of 39 basal cell carcinomas (BCC) (13 of superficial type, 7 infiltrating, 7 morphea-like, 12 nodular) and 20 trichoepitheliomas (TE) (9 of classic type, 9 immature, 2 desmoplastic). The labeling index (LI) was derived semiautomatically by means of a computer-assisted cellular image analyzer, and statistical analysis was carried out using the Student t test. A positive reaction for p27kip1 was detected in the hair germ papillae, in supramatrical cells, and in the inner pilar sheath, whereas matrical cells and the outer pilar sheath were negative. All BCC and TE cases showed a positive immunoreaction for p27kip1, but the staining pattern was different in the two groups of lesions, being patchy with focal peripheral accentuation in TE and more diffusely dispersed in BCC. The quantitative study showed lower p27kip1 expression in BCC (LI = 27.51 +/- 12.55) than in TE (LI = 45.27 +/- 20.27) (P < 0.0001). Statistically significant differences were also observed between TE subgroups and nodular or infiltrating BCC subtypes. The occurrence of a wide overlap of LI values hampers the practical application of a p27kip1 LI in the differential diagnosis between BCC and TE in difficult cases, however.
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Affiliation(s)
- Anna Maria Cesinaro
- Section of Pathological Anatomy, Department of Morphologic and Forensic Sciences, University of Modena and Reggio-Emilia, Modena, Italy.
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