Proliferating trichilemmal tumor: morphological considerations on its biological behaviour
Abstract: Proliferating trichilemmal tumor (PTT) is an adnexal neoplasm of the skin derived from the outer sheath of the hair follicle that frequently occurs on the scalp of elderly women. Although usually described as benign, cases with malignant transformation have been rep...
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| Formato: | Artículo revista |
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Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología
2021
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| Acceso en línea: | https://revistas.unc.edu.ar/index.php/med/article/view/34927 |
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I10-R327-article-34927 |
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ojs |
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Universidad Nacional de Córdoba |
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I-10 |
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R-327 |
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Revista de la Facultad de Ciencias Médicas de Córdoba |
| format |
Artículo revista |
| topic |
neoplasia hair follicle women neoplasia folículo piloso mujeres . |
| spellingShingle |
neoplasia hair follicle women neoplasia folículo piloso mujeres . Rivas, DA Defazio, ND Proliferating trichilemmal tumor: morphological considerations on its biological behaviour |
| topic_facet |
neoplasia hair follicle women neoplasia folículo piloso mujeres . |
| author |
Rivas, DA Defazio, ND |
| author_facet |
Rivas, DA Defazio, ND |
| author_sort |
Rivas, DA |
| title |
Proliferating trichilemmal tumor: morphological considerations on its biological behaviour |
| title_short |
Proliferating trichilemmal tumor: morphological considerations on its biological behaviour |
| title_full |
Proliferating trichilemmal tumor: morphological considerations on its biological behaviour |
| title_fullStr |
Proliferating trichilemmal tumor: morphological considerations on its biological behaviour |
| title_full_unstemmed |
Proliferating trichilemmal tumor: morphological considerations on its biological behaviour |
| title_sort |
proliferating trichilemmal tumor: morphological considerations on its biological behaviour |
| description |
Abstract:
Proliferating trichilemmal tumor (PTT) is an adnexal neoplasm of the skin derived from the outer sheath of the hair follicle that frequently occurs on the scalp of elderly women. Although usually described as benign, cases with malignant transformation have been reported but there are no clear morphological criteria to define this change except for clinical evidence of metastasis. A 60-year-old woman consulted for a 20-year evolution of a scalp tumor. Several pieces of tissue were received, the largest being 4.5 x 3.5 cm. and the rest, measured as a whole 3.7 x 3.5 cm. Among the latter were two pieces of hairy skin and a cyst with compact content. It was processed with routine techniques and stained with hematoxylin/eosin. Microscopy: histological sections showed a trichilemmal cyst with marked proliferation of the epithelium in the form of polypoid projections towards the lumen and wide and anastomosed tongues that formed wide nests towards the surrounding dermis, with evident atypia and frequent mitosis. In the center of the nests there was trichilemmal keratinization. The stroma was fibrous with a dense mononuclear inflammatory infiltrate. Surgical limits could not be assessed. Diagnosis: Proliferating trichilemmal tumor. A comment was added about the limitation to define biological behaviour only with the morphological study, also highlighting that the fragmentation of the material added difficulty to this interpretation. We do not have clinical information about the follow-up of the patient.
According to the bibliographic consultation, morphological considerations such as tumor size, atypia, mitosis and/or infiltrating borders are not sufficient to clearly define the biological behaviour of this tumor. In our case, the fragmentation of the material we received added difficulties in interpretation. PTT could be considered as a low-grade adnexal carcinoma of the skin rather than suggesting the existence of benign PTT. Therefore, complete surgical excision and strict monitoring of all cases are recommended because relapses and metastases are possible events.
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| publisher |
Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología |
| publishDate |
2021 |
| url |
https://revistas.unc.edu.ar/index.php/med/article/view/34927 |
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2024-09-03T21:02:47Z |
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2024-09-03T21:02:47Z |
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| spelling |
I10-R327-article-349272024-04-15T16:19:09Z Proliferating trichilemmal tumor: morphological considerations on its biological behaviour Tumor triquilemal proliferativo: consideraciones morfológicas sobre su comportamiento biológico A Rivas, DA Defazio, ND neoplasia hair follicle women neoplasia folículo piloso mujeres . Abstract: Proliferating trichilemmal tumor (PTT) is an adnexal neoplasm of the skin derived from the outer sheath of the hair follicle that frequently occurs on the scalp of elderly women. Although usually described as benign, cases with malignant transformation have been reported but there are no clear morphological criteria to define this change except for clinical evidence of metastasis. A 60-year-old woman consulted for a 20-year evolution of a scalp tumor. Several pieces of tissue were received, the largest being 4.5 x 3.5 cm. and the rest, measured as a whole 3.7 x 3.5 cm. Among the latter were two pieces of hairy skin and a cyst with compact content. It was processed with routine techniques and stained with hematoxylin/eosin. Microscopy: histological sections showed a trichilemmal cyst with marked proliferation of the epithelium in the form of polypoid projections towards the lumen and wide and anastomosed tongues that formed wide nests towards the surrounding dermis, with evident atypia and frequent mitosis. In the center of the nests there was trichilemmal keratinization. The stroma was fibrous with a dense mononuclear inflammatory infiltrate. Surgical limits could not be assessed. Diagnosis: Proliferating trichilemmal tumor. A comment was added about the limitation to define biological behaviour only with the morphological study, also highlighting that the fragmentation of the material added difficulty to this interpretation. We do not have clinical information about the follow-up of the patient. According to the bibliographic consultation, morphological considerations such as tumor size, atypia, mitosis and/or infiltrating borders are not sufficient to clearly define the biological behaviour of this tumor. In our case, the fragmentation of the material we received added difficulties in interpretation. PTT could be considered as a low-grade adnexal carcinoma of the skin rather than suggesting the existence of benign PTT. Therefore, complete surgical excision and strict monitoring of all cases are recommended because relapses and metastases are possible events. Resumen: El tumor triquilemal proliferativo (TTP) es una neoplasia anexial de la piel derivada de la vaina externa del folículo piloso que se presenta con frecuencia en cuero cabelludo en mujeres añosas. Aunque usualmente descripto como benigno, se han reportado casos con transformación maligna pero no hay criterios morfológicos claros para definir dicho cambio, salvo la evidencia clínica de metástasis. Mujer de 60 años que consultó por tumor de cuero cabelludo de 20 años de evolución. Se recibieron varios trozos de tejido, el mayor de 4,5 x 3,5 cm. y los restantes, medidos en conjunto 3,7 x 3,5 cm. Entre estos últimos habían dos losanges de piel con pelos y un quiste con contenido compacto. Se procesó con técnicas de rutina y se coloreó con hematoxilina/eosina. Microscopía: los cortes histológicos mostraron un quiste triquilemal con marcada proliferación del epitelio en forma de proyecciones polipoides hacia la luz y lengüetas anchas y anastomosadas que formaban amplios nidos hacia la dermis circundante, con atipia evidente y frecuentes mitosis. En el centro de los nidos había queratinización de tipo triquilemal. La estroma era fibrosa con denso infiltrado inflamatorio mononuclear. No fue posible evaluar los límites quirúrgicos. Diagnóstico: Tumor triquilemal proliferativo. Se agregó un comentario acerca de la limitación para definir comportamiento biológico sólo con el estudio morfológico, destacando además que la fragmentación del material sumó dificultad a esta interpretación. No disponemos de información clínica acerca del seguimiento de la paciente. De acuerdo con la consulta bibliográfica consideraciones morfológicas tales como tamaño tumoral, atipia, mitosis y/o bordes infiltrantes no son suficientes para definir claramente el comportamiento biológico de este tumor. En nuestro caso, la fragmentación del material recibido sumó dificultades en la interpretación. TTP podría ser considerado como un carcinoma anexial de bajo grado de la piel en lugar de plantear la existencia de TTP benigno. Por lo tanto es recomendable la excisión quirúrgica completa y el seguimiento estricto de todos los casos porque recaídas y metástasis son eventos posibles. . Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología 2021-10-12 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion texto texto texto https://revistas.unc.edu.ar/index.php/med/article/view/34927 Revista de la Facultad de Ciencias Médicas de Córdoba.; Vol. 78 No. Suplemento (2021): Suplemento JIC XXII Revista de la Facultad de Ciencias Médicas de Córdoba; Vol. 78 Núm. Suplemento (2021): Suplemento JIC XXII Revista da Faculdade de Ciências Médicas de Córdoba; v. 78 n. Suplemento (2021): Suplemento JIC XXII 1853-0605 0014-6722 http://creativecommons.org/licenses/by-nc/4.0 |