Trichilemmal carcinoma
Trichilemmal Carcinoma[edit | edit source]
Trichilemmal carcinoma is a rare skin cancer that originates from the outer root sheath of the hair follicle. It is considered a low-grade malignant tumor, meaning it has a low potential for metastasis but can be locally aggressive. This type of carcinoma is most commonly found on sun-exposed areas of the skin, particularly the scalp and face.
Pathophysiology[edit | edit source]
Trichilemmal carcinoma arises from the trichilemmal cyst, which is a benign cystic lesion derived from the outer root sheath of the hair follicle. The transformation from a benign trichilemmal cyst to a malignant carcinoma involves genetic mutations and environmental factors, such as ultraviolet radiation from sun exposure.
Clinical Presentation[edit | edit source]
Patients with trichilemmal carcinoma typically present with a solitary, nodular lesion that may be ulcerated or crusted. The lesion is often painless but can become tender if it becomes infected or ulcerated. The most common sites for these tumors are the scalp, face, and neck, areas that are frequently exposed to the sun.
Diagnosis[edit | edit source]
The diagnosis of trichilemmal carcinoma is confirmed through a biopsy of the lesion. Histopathological examination reveals atypical keratinocytes with trichilemmal differentiation, characterized by clear cell changes and abrupt keratinization without a granular layer. Immunohistochemical staining can aid in differentiating trichilemmal carcinoma from other skin neoplasms.
Treatment[edit | edit source]
The primary treatment for trichilemmal carcinoma is surgical excision with clear margins. Mohs micrographic surgery is often employed to ensure complete removal while preserving surrounding healthy tissue. In cases where surgery is not feasible, radiation therapy may be considered. Regular follow-up is essential to monitor for recurrence.
Prognosis[edit | edit source]
The prognosis for patients with trichilemmal carcinoma is generally favorable, given its low metastatic potential. However, local recurrence can occur, particularly if the tumor is not completely excised. Long-term follow-up is recommended to detect any recurrence early.
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