Arch Craniofac Surg.  2017 Mar;18(1):50-53. 10.7181/acfs.2017.18.1.50.

Trichilemmal Carcinoma from Proliferating Trichilemmal Cyst on the Posterior Neck

Affiliations
  • 1Department of Plastic and Reconstructive Surgery, Bundang CHA Medical Center, CHA University School of Medicine, Seongnam, Korea. chkimps@cha.ac.kr
  • 2Department of Pathology, Bundang CHA Medical Center, CHA University School of Medicine, Seongnam, Korea.

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.

Keyword

Epidermal cyst; Hair disease; Skin neoplasms; Skin appendage

MeSH Terms

Adult
Biopsy
Diagnosis
Drainage
Epidermal Cyst
Hair Diseases
Hair Follicle
Humans
Male
Neck*
Skin
Skin Neoplasms
Transplants
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