Abstract
Proliferating Trichilemmal Tumor (PTT) is a rare tumor of the outer root sheath of the hair follicle with different biological behavior. They usually develop in older patients, most commonly affecting women, from pre-existing pilar cyst. Histologically, this tumor may mimic squamous cell carcinoma (SCC). The standard of treatment is surgical excision with a margin of normal tissue. As most of the patients are not good surgical candidates, Radiotherapy plays an important role in the management of this tumor. We report a case of PTT on the occipital region of a 79-year-old female with its brief overview. In view of large size of the lesion and advanced age of the patient, Neoadjuvant Radiotherapy was planned and delivered. A near complete response of the lesion to radiotherapy was observed with good cosmesis. We discuss the role of radiotherapy in the management of PTT in various settings with literature review.
Keywords: Proliferating Trichilemmal Tumor, Proliferating Pilar Tumor, Radical Radiotherapy, Neoadjuvant radiotherapy, outer root sheath tumor, skin cancer, scalp tumor, cosmesis.
References
- JONES EW. Proliferating Epidermoid Cysts. Archives of Dermatology. 1966 Jul 1; 94(1):11.
- SATYAPRAKASH AK, SHEEHAN DJ, SANGÜEZA OP. Proliferating Trichilemmal Tumors: A Review of the Literature. Dermatologic Surgery. 2007 Sep;33(9):1102 -8
- Ye J, Nappi O, Swanson PE, Patterson JW, Wick MR. Proliferating Pilar Tumors. American Journal of Clinical Pathology. 2004 Oct;122(4):566–74.
- Mohan BP, Letha V, Anilkumar V. Malignant Proliferating Trichilemmal Tumor: A Rare Adnexal Neoplasm. Indian Journal of Dermatopathology and Diagnostic Dermatology [Internet]. 2020 Jan 1 [cited 2024 Jan 16];7(1):40. Available from: https://journals.lww.com/ijdd/Fulltext/2020/07010/Malignant_Proliferating_Trichilemmal_Tumor__A_Rare.12.aspx
- Manish Siddha, Ashwini Budrukkar, Tanuja Shet, Deshpande M, Basu A, Patil N, et al. Malignant pilar tumor of the scalp: A case report and review of literature. Journal of Cancer Research and Therapeutics. 2007 Jan 1 ;3(4):240–0.
- Shimizu Y, Sakita K, Arai E, Tsuchida T, Ogawa F, Ban S, et al. Clinicopathologic features of epidermal cysts of the sole: comparison with traditional epidermal cysts and trichilemmal cysts*. Journal of Cutaneous Pathology. 2005 Apr;32(4):280–5.
- Fieleke DR, Goldstein GD. Malignant Proliferating Trichilemmal Tumor Treated With Mohs Surgery. Dermatologic Surgery. 2015 Feb; 41(2):292–4.
- Sutherland D, Roth K, Yu E. Malignant Proliferating Trichilemmal Tumor Treated with Radical Radiotherapy: A Case Report and Literature Review. Cureus. 2017 Jan 26;
- Kearns-Turcotte S, Thériault M, Blouin MM. Malignant proliferating trichilemmal tumors arising in patients with multiple trichilemmal cysts: A case series. JAAD Case Reports. 2022 Apr;22:42–6.
- Ibrahim Halil KAFADAR, Melikgazi Öztürk, Beyza Aydın, Özlem Canöz, Orhun Eğilmez. Malignant proliferating trichilemmal tumor of the scalp: report of 4 cases and a short review of the literature. Case reports in plastic surgery & hand surgery [Internet]. 2022 May 23 [cited 2024 Jan 19];9(1):158–64. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9132464/
Corresponding Author
Dr Pranitha SL
Assistant Professor, Department of Radiation Oncology, Vydehi Institute of Medical Sciences & Research Centre, Bangalore, India
DOI: https://dx.doi.org/10.18535/jmscr/v12i02.11
