Eyelid trichoblastoma: an unusual localization

Adnexal neoplasms of the eye

Adnexal neoplasms of the eyelid encompass a wide variety of benign and malignant tumors of sebaceous, follicular, and sweat gland origin. Due to the specialized structures of the eyelid, these neoplasms present differently when compared with those of other locations. Although most dermatologists and ophthalmologists are familiar with the commonly reported adnexal tumors of the eyelid, such as hidrocystoma, pilomatrixoma, and sebaceous carcinoma, many other adnexal neoplasms have been reported at this unique anatomic site. Accurate and timely identification of these neoplasms is essential, as alterations of eyelid anatomy and function can have a negative impact on eye health, vision, and quality of life. We review the clinical and histopathologic features of common and rare eyelid adnexal neoplasms and discuss proposed treatment options.

Trichoblastomas Mimicking Basal Cell Carcinoma: The Importance of Identification and Differentiation

Trichoblastoma is a rare, slow-growing, benign cutaneous tumor derived from follicular germinative cells. Trichoblastoma commonly appears as an asymptomatic, symmetrical, well-circumscribed, skin-colored to brown or blue-black papule or nodule. It may appear clinically and histologically similar to basal cell carcinoma, making its diagnosis challenging. Even on dermoscopy, it is challenging to differentiate trichoblastoma from basal cell carcinoma. In practice, it is important to differentiate the two, because the choice of treatment and resulting prognosis differ between the lesions. Surgical biopsy to analyze histopathological and immunohistochemical differences is the gold standard for diagnosing and differentiating trichoblastoma from basal cell carcinoma. Trichoblastoma typically has a favorable prognosis, with a low incidence of recurrence, progression or association with malignancy. This paper provides a review of the epidemiology, clinical presentation, dermoscopy, histology, immunochemistry, treatment, and prognosis of trichoblastoma.

Trichoblastoma of lid: a masquerading tumour

A 62-year-old woman came to our hospital with complaints of painless gradual increase in dark coloured mass along inner canthus of the right eye. The surface of the mass was rough with a well-defined margin. No other systemic abnormality was detected. Wide margin excision was done and the excised mass was sent for histopathological examination. No skin grafting was done and the raw area was left for self-healing. In the next 3 weeks, skin growth over the raw area was observed and it was cosmetically acceptable. Histopathological examination revealed well-circumscribed tissue composed of aggregation of basaloid cells suggestive of trichoblastoma. Immunohistochemistry revealed positive staining of CD34 and CD10. Trichoblastoma is a rare entity seen in our clinical practice. Hence, a patient presenting with darker masses trichoblastoma can be considered as differential diagnosis.

Trichoblastoma of the Upper Eyelid

Purpose:

To describe a case of trichoblsatoma on the eyelid.

Case Report:

A 45-year-old woman presented with a recurring mass on her upper right eyelid. Histopathological examination revealed well-circumscribed tissue composed of an aggregation of basaloid cells. Immunohistochemistry showed positive staining for CD34 and CD10. The patient underwent total excision of the recurrent mass.

Conclusion:

Although rare, trichoblastoma should be considered in differential diagnosis of skin masses of the eyelids.

Trichoblastic fibroma of the eyelid

Trichoblastic fibroma (TBF), also known as trichoblastoma, small nodular type, is a rare benign cutaneous adnexal tumor that shows trichogenic (follicular) differentiation that can be mistaken clinically and histologically for basal cell carcinoma (BCC), a locally aggressive trichogenic carcinoma. As the clinical behaviors of these two follicular neoplasms are opposite from one another and their management is thus different, recognition of TBF is crucial for effective therapy. Although TBF most commonly is first seen on the face, this lesion has not previously been reported in the eyelid. In this report, we document the first case of TBF affecting the ocular adnexa and detail the histologic features that differentiate TBF from BCC.

Pigmented trichoblastoma arising from the nevus sebaceous: a rare case in Korea

Trichoblastoma is occasionally observed in association with a pre-existing nevus sebaceous in the Korean literature. However, there has been no report on the pigmented type. Herein, we report the first Korean case of a pigmented trichoblastoma arising from the nevus sebaceous on the forehead. A 28-year-old male presented with a dark nodular lesion within a yellowish plaque on the forehead. The surrounding yellowish plaque on the forehead had existed since birth. The central, dark-pigmented nodule began to appear three years ago and enlarged gradually. Histopathologic findings of central pigmented lesion showed heavy melanin deposits within and around the tumor nests. Complete excision was made as treatment.