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Lee V, Abdelmoneim SS, Sanchez-Dopazo R, Huayta M, Angly S, Frontela O. The Incidental Finding of Trichilemmal Cyst in a Patient With Acute Kidney Injury. Cureus 2024; 16:e64657. [PMID: 39149657 PMCID: PMC11326500 DOI: 10.7759/cureus.64657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2024] [Accepted: 07/16/2024] [Indexed: 08/17/2024] Open
Abstract
This case highlights the importance of thorough clinical examinations from head to toe and the early diagnosis of trichilemmal cysts. We present a case of an incidentally discovered trichilemmal cyst in a 72-year-old patient who presented with acute kidney injury secondary to a urinary tract infection. In rare instances, these cysts can transform into malignant lesions. Therefore, clinicians should be aware of the potential for malignancy when diagnosing and managing trichilemmal cysts.
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Affiliation(s)
- Vincent Lee
- Medicine, Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Fort Lauderdale, USA
| | - Sahar S Abdelmoneim
- Internal Medicine, Larkin Community Hospital Palm Springs Campus, Miami, USA
- General Internal Medicine/Cardiovascular Medicine, Assiut University Hospital, Assiut, EGY
| | | | - Miguel Huayta
- Internal Medicine, Larkin Community Hospital Palm Springs Campus, Miami, USA
- Medicine, Universidad Peruana de Ciencias Aplicadas, Lima, PER
| | - Sohair Angly
- Internal Medicine, Larkin Community Hospital Palm Springs Campus, Miami, USA
| | - Odalys Frontela
- Internal Medicine, Larkin Community Hospital Palm Springs Campus, Miami, USA
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Wang G, Zhou X, Luo J, Hu Q, Zhang J. Case report: Malignant proliferating trichilemmal tumor of the thumb. Front Oncol 2022; 12:1005206. [PMID: 36387268 PMCID: PMC9647022 DOI: 10.3389/fonc.2022.1005206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 10/13/2022] [Indexed: 11/29/2022] Open
Abstract
Proliferating trichilemmal tumor is a very rare benign tumor that has the potential to transition into a malignant tumor. PTT most commonly affects the scalps of women above 60 years old and is frequently misdiagnosed due to its rarity. Herein, we present a case of a 68-year-old man with a malignant proliferating trichilemmal tumor on his right thumb. X-ray image showed a soft tissue mass on his thumb accompanied by bone destruction, while 18F-FDG PET revealed a hypermetabolic mass in the first index with axillary lymph node metastasis.
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Affiliation(s)
- Guojie Wang
- Department of Radiology, Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China
- *Correspondence: Guojie Wang, ; Jie Zhang,
| | - Xuan Zhou
- Department of Pathology, Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China
| | - Junqi Luo
- Department of Radiology, Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China
| | - Qiyi Hu
- Department of Nuclear Medicine, Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China
| | - Jie Zhang
- Department of Radiology, Zhuhai People’s Hospital, Zhuhai, China
- *Correspondence: Guojie Wang, ; Jie Zhang,
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Kiel CM, Homøe P. Giant, Bleeding, and Ulcerating Proliferating Trichilemmal Cyst, With Delayed Treatment Due to Coronavirus Outbreak: A Case Report and Review of the Literature. Front Surg 2021; 8:680160. [PMID: 34901133 PMCID: PMC8660971 DOI: 10.3389/fsurg.2021.680160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2021] [Accepted: 10/25/2021] [Indexed: 11/13/2022] Open
Abstract
We report a case of a large, ulcerating proliferating trichilemmal cyst in a 76-year-old woman, with clinical, radiological, macroscopic, and microscopic correlation. The outbreak of the Coronavirus pandemic delayed her treatment. We review the literature on proliferating trichilemmal cysts, which are relatively rare tumors, which, generally, are considered benign. However, we found a high rate of malign cases, which stresses the importance of rapid surgical excision and histological diagnosis. Even though our proband had delayed treatment, the tumor did not transform into a malignant form.
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Affiliation(s)
- Cecilie Mullerup Kiel
- Department of Otorhinolaryngology and Maxillofacial Surgery, Zealand University Hospital, Roskilde, Denmark
| | - Preben Homøe
- Department of Otorhinolaryngology and Maxillofacial Surgery, Zealand University Hospital, Roskilde, Denmark
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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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Płachta I, Kleibert M, Czarnecka AM, Spałek M, Szumera-Ciećkiewicz A, Rutkowski P. Current Diagnosis and Treatment Options for Cutaneous Adnexal Neoplasms with Follicular Differentiation. Int J Mol Sci 2021; 22:4759. [PMID: 33946233 PMCID: PMC8125718 DOI: 10.3390/ijms22094759] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Revised: 04/21/2021] [Accepted: 04/23/2021] [Indexed: 12/30/2022] Open
Abstract
Neoplasms derived from follicular tissue are extremely rare. Clinically, they are reported as non-symptomatic, slow-growing nodules. These lesions are mainly benign, but the malignant type can occur. Mainly middle-aged people (50-60 years of age) are affected. These carcinomas are mainly localized on the head and neck or torso. They can be locally aggressive and infiltrate surrounding tissue and metastasize to regional lymph nodes. In the minority of cases, distant metastases are diagnosed. Quick and relevant diagnosis is the basis of a treatment for all types of tumors. The patient's life expectancy depends on multiple prognostic factors, including the primary tumor size and its mitotic count. Patients should be referred to a specialized skin cancer center to receive optimal multidisciplinary treatment. This article tries to summarize all the information that is currently available about pathogenesis, diagnosis, and treatment methods of follicular tumors.
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Affiliation(s)
- Iga Płachta
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland; (I.P.); (M.K.); (M.S.); (P.R.)
- Faculty of Medicine, Medical University of Warsaw, 02-091 Warsaw, Poland
| | - Marcin Kleibert
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland; (I.P.); (M.K.); (M.S.); (P.R.)
- Faculty of Medicine, Medical University of Warsaw, 02-091 Warsaw, Poland
| | - Anna M. Czarnecka
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland; (I.P.); (M.K.); (M.S.); (P.R.)
| | - Mateusz Spałek
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland; (I.P.); (M.K.); (M.S.); (P.R.)
| | - Anna Szumera-Ciećkiewicz
- Department of Pathology and Laboratory Diagnostics, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland;
- Department of Diagnostic Hematology, Institute of Hematology and Transfusion Medicine, 00-791 Warsaw, Poland
| | - Piotr Rutkowski
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland; (I.P.); (M.K.); (M.S.); (P.R.)
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Lakhani R, Khullar G, Sharma S. An unusual case of co-localization of proliferating trichilemmal tumor and seborrheic keratosis. Indian J Dermatol Venereol Leprol 2021; 87:551-554. [PMID: 33969650 DOI: 10.25259/ijdvl_817_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Accepted: 12/01/2020] [Indexed: 11/04/2022]
Affiliation(s)
- Ridhima Lakhani
- Department of Dermatology and Sexually Transmitted Diseases, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
| | - Geeti Khullar
- Department of Dermatology and Sexually Transmitted Diseases, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
| | - Shruti Sharma
- Department of Pathology, National Institute of Pathology (Indian Council of Medical Research), Safdarjung Hospital Campus, New Delhi, India
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Kim UG, Kook DB, Kim TH, Kim CH. Trichilemmal Carcinoma from Proliferating Trichilemmal Cyst on the Posterior Neck. Arch Craniofac Surg 2017; 18:50-53. [PMID: 28913304 PMCID: PMC5556745 DOI: 10.7181/acfs.2017.18.1.50] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2016] [Revised: 02/08/2017] [Accepted: 02/08/2017] [Indexed: 11/11/2022] Open
Abstract
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.
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Affiliation(s)
- Ui Geon Kim
- Department of Plastic and Reconstructive Surgery, Bundang CHA Medical Center, CHA University School of Medicine, Seongnam, Korea
| | - Dong Bee Kook
- Department of Plastic and Reconstructive Surgery, Bundang CHA Medical Center, CHA University School of Medicine, Seongnam, Korea
| | - Tae Hun Kim
- Department of Pathology, Bundang CHA Medical Center, CHA University School of Medicine, Seongnam, Korea
| | - Chung Hun Kim
- Department of Plastic and Reconstructive Surgery, Bundang CHA Medical Center, CHA University School of Medicine, Seongnam, Korea
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