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Review
. 2023 Jun 23;102(25):e34035.
doi: 10.1097/MD.0000000000034035.

A malignant proliferating trichilemmal cyst arising on the elbow of a man: A case report and review of the literature

Dong Yun Lee  1 , Kang Min Han  1 , Jung Soo Yoon  1
Affiliations
Review

A malignant proliferating trichilemmal cyst arising on the elbow of a man: A case report and review of the literature

Dong Yun Lee et al. Medicine (Baltimore). .

Abstract

Introduction: Trichilemmal cysts (TCs) are common benign cysts that form from the hair follicles in the skin. Proliferating trichilemmal cysts (PTCs) are rare types of TCs characterized by rapid cellular proliferation. Malignant transformation of PTC (MPTC) is a rare adnexal tumor that account for <0.1% of all skin cancers. TCs and PTCs are benign tumors; however, MPTCs grow rapidly and are prone to metastasis.

Case presentation: A 77-year-old man was referred to our hospital with a solitary pinkish mass on his left elbow. Trichilemmal carcinoma arising from a PTC was confirmed through excisional biopsy, and wide excision was performed. One month postoperatively, a cystic mass was observed and was suspected to have local recurrence; however, bursitis was confirmed after excisional biopsy. After 1 year of follow-up, the patient maintained an improvement without recurrence or any other surgical complications.

Conclusions: In addition to being a very rare disease, MTPC occurred in the elbow of a man who does not fit the general etiology; therefore, it is considered an interesting case, and we report this case for academic contribution.

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Conflict of interest statement

The authors have no funding and conflicts of interest to disclose.

Figures

Figure 1.
Figure 1.
(A) Preoperative clinical photo. (B) The sagittal view of preoperative non-contrast computed tomographic image showing a subcutaneous cystic lesion at the posterior aspect of the radiocapitellar joint without invasion of deep structures.
Figure 2.
Figure 2.
Histologic findings of malignant proliferating trichilemmal cyst. An excisional biopsy showing a fragmented collapsed cystic lesion in the dermis. The cystic lesion is lined with acanthotic stratified squamous epithelium with a central necrotic keratin material. The lining of the squamous epithelium shows abrupt keratinization without a granular cell layer (A, H&E, ×40). In contrast, irregular epithelial nests are found in an area adjacent to the proliferating trichilemmal cyst. The irregular epithelial nests reveal an infiltrative growth pattern and display pilar-type keratinization in the absence of granular cells, which indicates malignant transformation of proliferating trichilemmal cysts (B. H&E, ×100).
Figure 3.
Figure 3.
Clinical photo at 1 yr postoperatively.
See this image and copyright information in PMC

References

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