Background: Proliferating trichilemmal tumors are slow-growing lobulated masses most commonly found on the scalp of elderly women. Due to the locally invasive nature of the lesion, the treatment is complete excision o...Background: Proliferating trichilemmal tumors are slow-growing lobulated masses most commonly found on the scalp of elderly women. Due to the locally invasive nature of the lesion, the treatment is complete excision of the tumor with tumor-free margins. Methods: We present two cases of trichilemmal tumors that exhibited aggressive local invasion across tissue planes. The first case had dural invasion, which needed dural reconstruction. The second case had muscle invasion, which required wide resection. Results: Sixteen months after their surgeries, the patients are in good health without any recurrence of tumors. Conclusion: Trichilemmal tumors may exhibit aggressive local invasion across tissue planes and even penetrate intracranially, causing considerable morbidity and mortality. The possibility of dural and muscle invasion must be kept in mind in order to achieve successful treatment results. A close clinical follow-up is judicious for detecting recurrences or metastases.展开更多
BACKGROUND Malignant proliferating trichilemmal tumor(MPTT)is an infrequent malignant neoplasm originating from cutaneous appendages,with only a handful of documented cases.This report delineates a unique instance of ...BACKGROUND Malignant proliferating trichilemmal tumor(MPTT)is an infrequent malignant neoplasm originating from cutaneous appendages,with only a handful of documented cases.This report delineates a unique instance of MPTT situated in the neck,accompanied by lymph node metastasis.A comprehensive exposition of its clinical trajectory and imaging manifestation is presented,aiming to enhance comprehension and management of this atypical ailment.CASE SUMMARY Patient concerns:A 79-year-old male presented with a longstanding right neck mass persisting for over six decades,exhibiting recent enlargement over the past year.Diagnoses:Enhanced magnetic resonance imaging of the neck unveiled an elliptical mass on the right neck side,characterized by an ill-defined border and a heterogeneous signal pattern.The mass exhibited subdued signal intensity on T1-weighted imaging(T1WI)and a heterogeneous high signal on T2-weighted imaging(T2WI),interspersed with a lengthy T1 and T2 cystic signal motif.Close anatomical association with the submandibular gland joint was noted,and intravenous gadolinium diethylene triamine pentaacetic acid administration facilitated conspicuous enhancement.Substantial enhancement of the solid segment prompted an initial preoperative diagnosis of malignant nerve sheath tumor.However,post-surgery histopathological and immunohistochemical analysis conclusively confirmed the diagnosis as malignant hyperplastic external hair root sheath tumor.Intervention:Complete excision of the tumor was successfully executed.Outcomes:The patient experienced a favorable postoperative recovery.CONCLUSION Malignant proliferative trichilemmal tumor external hair root sheath tumor is a cystic-solid lesion,appearing as low signal on T1WI images or high signal on T2WI with enhancement of the solid component.Suspicions of malignancy are heightened when the tumor border is indistinct,tissue planes are breached,or when linear or patchy high signals are observed in the subcutaneous tissue on T1 liver acquisition with volume acceleration enhanced images along with intermediate signal on T2WI and restricted diffusion on diffusion-weighted imaging images.Strong consideration for malignancy should arise if there are signs of compromised adjacent tissue relationships or direct invasion evident on imaging.We have incorporated the above-mentioned content into the entire manuscript.展开更多
Malignant tumors arising from follicular cysts are rare. Herein, we report of a 62-year-old Japanese woman with a slowly growing tumor, 22 × 20 mm in size, located on her nose for 2 years. Histopathological exami...Malignant tumors arising from follicular cysts are rare. Herein, we report of a 62-year-old Japanese woman with a slowly growing tumor, 22 × 20 mm in size, located on her nose for 2 years. Histopathological examination of the surgically excised tumor showed that the tumor cells were basaloid and formed peripheral palisading patterns. The tumor contained a cystic structure in its center, and the cyst wall was lined with stratified epithelium with or without keratohyalin granules. Based on these findings, a diagnosis of basal cell carcinoma arising from a follicular hybrid cyst was made. To our knowledge, this is the first case of basal cell carcinoma originating from a follicular hybrid cyst. A review of previous reports of basal cell carcinoma from a follicular cyst indicated that the majority of previous cysts were located on the face, and that the lesions had been present for a relatively long time. The present case showed typical clinical findings and followed a regular course. Malignant transformation may be a rare event, but it can occur in a follicular cyst, so cysts and suspected cysts, especially those found on the face and those persisting for relatively long time, should always be subjected to histological examination.展开更多
文摘Background: Proliferating trichilemmal tumors are slow-growing lobulated masses most commonly found on the scalp of elderly women. Due to the locally invasive nature of the lesion, the treatment is complete excision of the tumor with tumor-free margins. Methods: We present two cases of trichilemmal tumors that exhibited aggressive local invasion across tissue planes. The first case had dural invasion, which needed dural reconstruction. The second case had muscle invasion, which required wide resection. Results: Sixteen months after their surgeries, the patients are in good health without any recurrence of tumors. Conclusion: Trichilemmal tumors may exhibit aggressive local invasion across tissue planes and even penetrate intracranially, causing considerable morbidity and mortality. The possibility of dural and muscle invasion must be kept in mind in order to achieve successful treatment results. A close clinical follow-up is judicious for detecting recurrences or metastases.
文摘BACKGROUND Malignant proliferating trichilemmal tumor(MPTT)is an infrequent malignant neoplasm originating from cutaneous appendages,with only a handful of documented cases.This report delineates a unique instance of MPTT situated in the neck,accompanied by lymph node metastasis.A comprehensive exposition of its clinical trajectory and imaging manifestation is presented,aiming to enhance comprehension and management of this atypical ailment.CASE SUMMARY Patient concerns:A 79-year-old male presented with a longstanding right neck mass persisting for over six decades,exhibiting recent enlargement over the past year.Diagnoses:Enhanced magnetic resonance imaging of the neck unveiled an elliptical mass on the right neck side,characterized by an ill-defined border and a heterogeneous signal pattern.The mass exhibited subdued signal intensity on T1-weighted imaging(T1WI)and a heterogeneous high signal on T2-weighted imaging(T2WI),interspersed with a lengthy T1 and T2 cystic signal motif.Close anatomical association with the submandibular gland joint was noted,and intravenous gadolinium diethylene triamine pentaacetic acid administration facilitated conspicuous enhancement.Substantial enhancement of the solid segment prompted an initial preoperative diagnosis of malignant nerve sheath tumor.However,post-surgery histopathological and immunohistochemical analysis conclusively confirmed the diagnosis as malignant hyperplastic external hair root sheath tumor.Intervention:Complete excision of the tumor was successfully executed.Outcomes:The patient experienced a favorable postoperative recovery.CONCLUSION Malignant proliferative trichilemmal tumor external hair root sheath tumor is a cystic-solid lesion,appearing as low signal on T1WI images or high signal on T2WI with enhancement of the solid component.Suspicions of malignancy are heightened when the tumor border is indistinct,tissue planes are breached,or when linear or patchy high signals are observed in the subcutaneous tissue on T1 liver acquisition with volume acceleration enhanced images along with intermediate signal on T2WI and restricted diffusion on diffusion-weighted imaging images.Strong consideration for malignancy should arise if there are signs of compromised adjacent tissue relationships or direct invasion evident on imaging.We have incorporated the above-mentioned content into the entire manuscript.
文摘Malignant tumors arising from follicular cysts are rare. Herein, we report of a 62-year-old Japanese woman with a slowly growing tumor, 22 × 20 mm in size, located on her nose for 2 years. Histopathological examination of the surgically excised tumor showed that the tumor cells were basaloid and formed peripheral palisading patterns. The tumor contained a cystic structure in its center, and the cyst wall was lined with stratified epithelium with or without keratohyalin granules. Based on these findings, a diagnosis of basal cell carcinoma arising from a follicular hybrid cyst was made. To our knowledge, this is the first case of basal cell carcinoma originating from a follicular hybrid cyst. A review of previous reports of basal cell carcinoma from a follicular cyst indicated that the majority of previous cysts were located on the face, and that the lesions had been present for a relatively long time. The present case showed typical clinical findings and followed a regular course. Malignant transformation may be a rare event, but it can occur in a follicular cyst, so cysts and suspected cysts, especially those found on the face and those persisting for relatively long time, should always be subjected to histological examination.
