Giant trichilemmal cyst of scrotum

Abstract

A 45-year-old man with an asymptomatic lesion on the scrotum since 25 years presented to the skin out patient department (OPD). There were multiple skin-colored to hyperpigmented nodules with areas of calcification on the scrotum. The mass measured 20 cm × 10 cm × 8 cm as a whole. Steatocystoma was clinically diagnosed and excision of the lesion was performed by a plastic surgeon. The mass was removed en masse and the removed specimen was measured to be 20 cm × 10 cm × 5 cm. On histopathological examination, the cysts showed epithelium resembling that of outer hair root sheath. Contents of the cysts were homogenous unlamellated keratin with focal calcification.

Keywords: Adnexal tumor; Giant trichilemmal cyst; Pilar cyst; Steatocystoma multiplex; Trichilemmal cyst.

Figure 1:

Preoperative clinical picture of scrotal cysts as seen from the front.

Figure 2:

Histopathological picture showing cross-section of a cystic cavity lined by keratinized epithelium without granular layer.