Ann Dermatol.  2008 Sep;20(3):157-161. 10.5021/ad.2008.20.3.157.

A Case of Trichilemmal Carcinoma Treated with Mohs Micrographic Surgery

• Kim YH
• Lee YK
• Choi KW
• Lee CY
• Kim KH

• KMID: 2156385
• DOI: http://doi.org/10.5021/ad.2008.20.3.157

Abstract

Trichilemmal carcinoma is a cutaneous adnexal tumor originating from the outer root sheath of hair follicle, and it was first described by Headington in 1976. Clinically, it usually occurs as an asymptomatic solitary papule, nodule or mass on the face or scalp. This neoplasm is a malignant counterpart of trichilemmoma, and it has been reported in the literature as trichilemmal carcinoma, tricholemmal carcinoma, malignant trichilemmoma, and tricholemmocarcinoma. Although histologically, trichilemmal carcinoma frequently has maliganant features, it has a relatively benign clinical behavior. We think Mohs micrographic surgery is a useful treatment modality in trichilemmal carcinoma because the final skin defect is smaller than a wide excision. We report a case of primary trichilemmal carcinoma which had developed on the face, treated with Mohs micrographic surgery.

Keyword

Mohs micrographic surgery; Trichilemmal carcinoma

MeSH Terms

Hair Follicle
Mohs Surgery
Scalp
Skin

Figure

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  Fig. 1 1.0×1.0 cm sized ulcerative plaque on the left cheek for 2 years.

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  Fig. 2 (A) Infiltrative epithelial lobules and clear cells extended downward from the epidermis (H& E stain, ×40). (B) Nuclear pleomorphism and mitotic figures are remarkable and clear cells were in palisading arragement (H& E stain, ×200).

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  Fig. 3 (A) Ki-67 positive cells are diffusely present in tumor lobules (Ki-67 stain, ×100). (B, C) Tumor lobules were strongly positive for p53 and p63 (p53 protein, p63 stain, ×100).

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