Ahmad A, Salman FM, Jeragh F, Dashti Y. Enemy in disguise: A case report of solitary trichoepithelioma initially diagnosed as BCC.
Int J Surg Case Rep 2023;
103:107897. [PMID:
36701902 PMCID:
PMC9883285 DOI:
10.1016/j.ijscr.2023.107897]
[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: 09/19/2022] [Revised: 01/09/2023] [Accepted: 01/09/2023] [Indexed: 01/15/2023] Open
Abstract
INTRODUCTION
Solitary trichoepitheliomas (TE) are benign tumors that are strikingly similar to their malignant counterpart, basal cell carcinoma (BCC).
PRESENTATION OF CASE
An 83-year-old man presented with a 10-year history of a right lower lid skin mass initially diagnosed as BCC. Intraoperatively, an excisional biopsy was performed with primary reconstruction of the skin defect and the specimen was submitted for histopathology processing. Eventually, histopathology findings suggested the diagnosis of benign hair follicle tumor. The postoperative results were aesthetically pleasing and the integrity of the lower lid was preserved.
DISCUSSION
Despite being rare, benign solitary TE are frequently misdiagnosed as malignant BCC, and vice versa. Oculoplastic surgeons face considerable difficulty distinguishing the two pathologies due to their similar clinical and histological pictures. Hence, excisional biopsy should be considered whenever such discrepancy is confronted to avoid the possibility of recurrence or malignant transformation. Furthermore, immunohistochemical staining could increase the accuracy of diagnosis in such unequivocal findings.
CONCLUSION
Correlation of clinical, dermoscopic and histopathological findings are essential to establish an accurate diagnosis and select the appropriate management. In-depth understanding of eyelid reconstruction principles is mandatory to achieve desirable goals.
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