Trichofolliculoma: a Confusing Benign Tumor
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Dermoscopic Features of Trichoadenoma
Dermatology Practical & Conceptual Broadening the List of Basal Cell Carcinoma Mimickers: Dermoscopic Features of Trichoadenoma Riccardo Pampena1, Stefania Borsari1, Simonetta Piana2, Caterina Longo1,3 1 Centro Oncologico ad Alta Tecnologia Diagnostica, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Italy 2 Pathology Unit, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Italy 3 Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy Key words: trichoadenoma, basal cell carcinoma, adnexal tumors, dermoscopy Citation: Pampena R, Borsari S, Piana S, Longo C. Broadening the list of basal cell carcinoma mimickers: dermoscopic features of trichoadenoma. Dermatol Pract Concept. 2019;9(2):160-161. DOI: https://doi.org/10.5826/dpc.0902a17 Accepted: January 10, 2019; Published: April 30, 2019 Copyright: ©2019 Pampena et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Funding: This research was supported by Italian Ministry of Health (Project Code: NET-2011-02347213). Competing interests: The authors have no conflicts of interest to disclose. Authorship: All authors have contributed significantly to this publication. Corresponding author: Riccardo Pampena, MD, Centro Oncologico ad Alta Tecnologia Diagnostica, Azienda Unità Sanitaria Locale – IRCCS, Viale Risorgimento 80, 42123, Reggio Emilia, Italy. Email: [email protected] Introduction Case Presentation A wide spectrum of skin tumors may mimic basal cell carci- Dermoscopic evaluation was performed with a contact polar- noma (BCC) on both clinical and dermoscopic appearance. ized dermatoscope (DermLite Foto, 3Gen LLC, Dana Point, Among these, adnexal skin neoplasms and in particular CA, USA) and showed a general BCC-like appearance. -
Eyelid Conjunctival Tumors
EYELID &CONJUNCTIVAL TUMORS PHOTOGRAPHIC ATLAS Dr. Olivier Galatoire Dr. Christine Levy-Gabriel Dr. Mathieu Zmuda EYELID & CONJUNCTIVAL TUMORS 4 EYELID & CONJUNCTIVAL TUMORS Dear readers, All rights of translation, adaptation, or reproduction by any means are reserved in all countries. The reproduction or representation, in whole or in part and by any means, of any of the pages published in the present book without the prior written consent of the publisher, is prohibited and illegal and would constitute an infringement. Only reproductions strictly reserved for the private use of the copier and not intended for collective use, and short analyses and quotations justified by the illustrative or scientific nature of the work in which they are incorporated, are authorized (Law of March 11, 1957 art. 40 and 41 and Criminal Code art. 425). EYELID & CONJUNCTIVAL TUMORS EYELID & CONJUNCTIVAL TUMORS 5 6 EYELID & CONJUNCTIVAL TUMORS Foreword Dr. Serge Morax I am honored to introduce this Photographic Atlas of palpebral and conjunctival tumors,which is the culmination of the close collaboration between Drs. Olivier Galatoire and Mathieu Zmuda of the A. de Rothschild Ophthalmological Foundation and Dr. Christine Levy-Gabriel of the Curie Institute. The subject is now of unquestionable importance and evidently of great interest to Ophthalmologists, whether they are orbital- palpebral specialists or not. Indeed, errors or delays in the diagnosis of tumor pathologies are relatively common and the consequences can be serious in the case of malignant tumors, especially carcinomas. Swift diagnosis and anatomopathological confirmation will lead to a treatment, discussed in multidisciplinary team meetings, ranging from surgery to radiotherapy. -
A Clinico-Histopathological Study of Cutaneous Appendageal Tumours
IP Indian Journal of Clinical and Experimental Dermatology 5 (2019) 206–210 Content available at: iponlinejournal.com IP Indian Journal of Clinical and Experimental Dermatology Journal homepage: www.innovativepublication.com Original Research Article A clinico-histopathological study of cutaneous appendageal tumours Gowda Monika M1, S Sathish K1, M Basavarajaiah D2,* 1Kempegowda Institute of Medical Sciences, Bengaluru, Karnataka, India 2Dept. of Dermatology, KVAFSU B Hebbal, Bidar, Karnataka, India ARTICLEINFO ABSTRACT Article history: The cutaneous appendageal tumors are an ideal subject for study from clinical and morphological point Received 01-08-2019 of view and so ubiquitous that they can affect people of all age group A histopathological study of 100 Accepted 13-08-2019 cases of cutaneous appendageal tumors was carried out at tertiary care hospital over 18 months. A Total Available online 14-09-2019 95 cases were benign and 5 cases were malignant tumors, constituting 95.0 % p<0.01 and 5.0 % p>0.01 respectively. Sweat gland tumors were the most common manifestation (79.0% ) p<0.01, followed by hair follicle tumors (20%) and eccrine duct tumors 1(1%). Male and female ratio was 27:73. The commonest Keywords: affected body site was head and neck region . The mean age was 36.58 1.22 years . Out of 95 cases cutaneous appendageal tumors of benign tumors, syringoma accounted for 48% (48), trichoepithelioma12 p<0.01, eccrine hydrocystoma malignant (11) p<0.01 ,trichofolliculoma, Apocrine hydrocystoma and nodular hidradenomaeach (4)p>0.01. Total histopathologically (39) p<0.01 are correlating both clinically and histopathologically and (61) p<0.01 are not correlating clinically clinically and histopathologically. -
The Best Diagnosis Is: H&E, Original Magnification 2
Dermatopathology Diagnosis The best diagnosis is: H&E, original magnification 2. a. adenoid cysticcopy carcinoma arising within a spiradenoma b. cylindroma and spiradenoma collision tumor c. microcysticnot change within a spiradenoma d. mucinous carcinoma arising within a spiradenoma Doe. trichoepithelioma and spiradenoma collision tumor CUTIS H&E, original magnification 100. PLEASE TURN TO PAGE 211 FOR DERMATOPATHOLOGY DIAGNOSIS DISCUSSION Amanda F. Marsch, MD; Jeffrey B. Shackelton, MD; Dirk M. Elston, MD Dr. Marsch is from the Department of Dermatology, University of Illinois at Chicago. Drs. Shackelton and Elston are from the Ackerman Academy of Dermatopathology, New York, New York. The authors report no conflict of interest. Correspondence: Amanda F. Marsch, MD, University of Illinois at Chicago, 808 S Wood St, Chicago, IL 60612 ([email protected]). 192 CUTIS® WWW.CUTIS.COM Copyright Cutis 2015. No part of this publication may be reproduced, stored, or transmitted without the prior written permission of the Publisher. Dermatopathology Diagnosis Discussion Trichoepithelioma and Spiradenoma Collision Tumor he coexistence of more than one cutaneous adnexal neoplasm in a single biopsy specimen Tis unusual and is most frequently recognized in the context of a nevus sebaceous or Brooke-Spiegler syndrome, an autosomal-dominant inherited disease characterized by cutaneous adnexal neoplasms, most commonly cylindromas and trichoepitheliomas.1-3 Brooke-Spiegler syndrome is caused by germline muta- tions in the cylindromatosis gene, CYLD, located on band 16q12; it functions as a tumor suppressor gene and has regulatory roles in development, immunity, and inflammation.1 Weyers et al3 first recognized the tendency for adnexal collision tumors to present in patients with Brooke-Spiegler syndrome; they reported a patient with Brooke-Spiegler syndrome with spirad- Figure 1. -
Pilomatricoma: a Case Report
Open Access Austin Journal of Dermatology Case Report Pilomatricoma: A Case Report Jayakar Thomas*, Tamilarasi S, Asha D and Zohra Begum C Abstract Department of Dermatology, Sree Balaji Medical College Pilomatricoma is a benign tumor that arises from hair follicle matrical cells. & Bharath University, India Involvement of the upper limb is relatively uncommon and can be mistaken for *Corresponding author: Jayakar Thomas, other soft tissue tumors. We report the case of a 12 year old boy, who presented Department of Dermatology, Sree Balaji Medical College with an asymptomatic firm nodule over the left arm whose histology was & Bharath University, Chennai 600044, India, Email: suggestive of Pilomatricoma. [email protected] Keywords: Pilomatricoma; Shadow cells; Ghost cells; Basaloid cells Received: April 05, 2015; Accepted: May 29, 2015; Published: June 02, 2015 Introduction 1). The neurovascular status of the left hand was noted to be intact; there were no other palpable masses in the extremities and no axillary Pilomatricoma also known as Pilomatrixoma or calcifying adenopathy was present. Excision biopsy was performed under epithelioma of Malherbe is a benign neoplasm, which is derived regional anesthesia. Grossly the tumor was white in appearance and from hair follicle matrix cells. These tumors are typically present well circumscribed. in the head and neck region, but also occur in the upper limbs and are rarely reported in other sites[1].Pilomatricoma represents as an Histopathology revealed a capsulated benign neoplasm over asymptomatic, solitary, firm to hard, freely mobile nodule of the the subcutis, composed of lobules ofirregularly shaped masses of dermis or subcutaneous tissue. These tumors are generally exhibits ghost or shadow cells, scattered basophilic cells that undergo abrupt no fixation to neighbouring tissues and have an osseous- or cartilage- keratinization forming ghost [shadow] cells and areas of calcification. -
Hidrocystoma Multiplex
Case Reports Hidrocystoma Multiplex Dr. W. K. Yu and puncture resulted in collapse of the cyst with Date: 13 October, 1999 drainage of clear watery fluid. Venue: Yaumatei Skin Centre Organizer: Social Hygiene Service, DH; Clinico-pathological Seminar Differential diagnoses The possible diagnoses for numerous asymptomatic small facial papules included hidrocystoma, plane warts, seborrhoeic keratoses, milia, CASE SUMMARY xanthelasma, syringoma, trichoepithelioma, tricholemmoma and sebaceous hyperplasia. History A 48-year-old housewife complained of multiple asymptomatic papules on her face for over ten years, Investigations and diagnosis gradually becoming more numerous. There was an Biopsy was done on one of the biggest papules increase in size and number of the papules on exposure beneath the left eye. Histology showed a small cyst of to heat or after exercise. The condition was worse in 0.2 cm in the dermis. The cyst was lined by a double summer. She had no family history of similar facial layer of polygonal cuboidal epithelial cells of the sweat eruption. gland with irregular border. No papillary invagination or tadpole-like strand was seen. The features were consistent with hidrocystoma multiplex (Figures 2 and Physical examination 3). There were numerous skin-coloured, small, smooth, oval or round papules of 1-3 mm in diameter on the face (Figure 1). They were most numerous around Management the eyes. Some of the lesions had a cystic appearance The patient was advised about the benign nature Figure 1: Multiple small cystic papules on the face Vol.8 No.2, June 2000 71 Case Reports Figure 2: Low power view showing a cystic tumour in the mid dermis. -
A Dilated Pore of Winer with Four Openings Ru-Zhi Zhang1 and Wen-Yuan Zhu*,2
Send Orders for Reprints to [email protected] 10 The Open Dermatology Journal, 2015, 9, 10-11 Open Access A Dilated Pore of Winer with Four Openings Ru-Zhi Zhang1 and Wen-Yuan Zhu*,2 1Department of Dermatology, Third Affiliated Hospital of Suzhou University, 185 Juqian Road, Changzhou, 213003, China 2Department of Dermatology, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China Abstract: Dilated pore was originally designated as a secondary or acquired trichoepithelioma by Winer, represents an appendageal tumor with differentiation towards hair structures. It is clinically characterized by having the appearance of a large blackhead filled with keratinous material. To the best of our knowledge, there has been no report of a dilated pore with four openings. We herein describe such a case. Keywords: Dilated pore, nodule. INTRODUCTION Dilated pore was described by Winer [1] in 1954 as an enlarged solitary pore filled with a plug of keratin seen predominately on the face of adult men. It has the histologic appearance of a large cystic cavity, which is filled with basket weave cornified debris that simulates the normal stratum corneum although it may be thickened and more compact. We report an unusual dilated pore of Winer with four openings. CASE REPORT A 68-year-old man presented with a 35-year-history of asymptomatic, gradually increasing nodule with four heads on the left chest. The patient did not have a past history of severe acne and denied any preceding trauma or scratch on this site. He had no concomitant dermatological diseases, thyroid dysfunction or any other autoimmune disease. -
Solitary Nodule with White Hairs
PHOTO CHALLENGE Solitary Nodule With White Hairs Megan Wetzel, MD, MPH; Amy Gagnon, MD; Joseph McDermott, MD A 72-year-old man presented with a new asymp- tomatic 0.7-cm flesh-colored papule with a cen- tral tuft of white hairs on the posterior scalp. The remainder of the physical examination was unre- markable. Biopsy for histopathologic examination was performed to confirm diagnosis. WHAT’S THEcopy DIAGNOSIS? a. dilated pore of Winer b. epidermoid cyst c. pilar sheath acanthoma d. trichoepitheliomanot e. trichofolliculoma DoPLEASE TURN TO PAGE E2 FOR THE DIAGNOSIS CUTIS Dr. Wetzel was from the University of Vermont, Burlington, and currently is from the Division of Dermatology, Department of Internal Medicine, University of Louisville School of Medicine, Kentucky. Drs. Gagnon and McDermott were from the University of Virginia, Charlottesville. Dr. Gagnon currently is from Dermatology PLC, Charlottesville and Orange, Virginia. Dr. McDermott currently is from the Department of Pathology and Laboratory Services, David Grant Medical Center, Fairfield, California. The authors report no conflict of interest. The opinions or assertions contained herein are the private views of the authors and are not to be construed as official or as reflecting the views of the Department of the Air Force or the Department of Defense. Correspondence: Megan Wetzel, MD, MPH, 3810 Springhurst Blvd, Louisville, KY 40241 ([email protected]). WWW.CUTIS.COM VOL. 100 NO. 2 I AUGUST 2017 E1 Copyright Cutis 2017. No part of this publication may be reproduced, stored, or transmitted without the prior written permission of the Publisher. PHOTO CHALLENGE DISCUSSION THE DIAGNOSIS: Trichofolliculoma icroscopic examination revealed a dilated cystic Clinically, the differential diagnosis of a flesh-colored follicle that communicated with the skin surface papule on the scalp with prominent follicle includes M(Figure). -
A Rare Case of Trichilemmal Carcinoma: Histology and Management
A rare case of Trichilemmal Carcinoma: histology and management Lisa Fronek DO, Allyson Brahs BS, Maheera Farsi DO, Richard Miller DO, Dudith Pierre-Victor, PhD, MPH HCA Healthcare USF Morsani College of Medicine: Largo Medical Center Program Western University of Heath Sciences, College of Osteopathic Medicine of the Pacific Introduction Clinical and Histologic Findings Discussion Trichilemmal carcinoma (TC) is a rare, malignant, adnexal neoplasm that is TC is a rare, adnexal tumor with evidence for follicular ORS or trichilemmal derived from the outer root sheath (ORS) of the hair follicle. These tumors differentiation. It is considered the malignant analogue of trichilemmoma. predominantly occur in elderly patients on sun-exposed areas, specifically on Clinical presentation is variable; due to its ability to resemble different clinical the head and neck with the face defined as the most common location. The entities, the diagnosis of TC relies on histological evaluation, accompanied by mean age of diagnosis is 70 years old with a slight male predominance. IHC. Microscopically, TC features a solid, lobular, or trabecular growth pattern These lesions are commonly identified as a papular, nodular, and sometimes, often centered around a pilosebaceous unit. The tumor cells are clear, exophytic. They generally arise de-novo, but may also derivate from an polygonal, and glycogen-rich (periodic acid-Schiff positive (PAS), diastase underlying proliferating trichilemmal cyst with a loss of p53, a seborrheic sensitive), reminiscent of clear cells of the ORS. It exhibits peripheral keratosis, a nevus sebaceous, or a scar. They can be locally aggressive and palisading of basaloid cells abutting a sometimes thickened hyalinized may exhibit telangiectasias and ulceration due to local destruction. -
Trichoadenoma of the Upper Lip Gian Paolo Bombeccari, Gianpaolo Guzzi, Umberto Mariani, Andrea Gianatti, Diego Ruffoni, Franco Santoro, Francesco Spadari
CASE REPORTS SCIENTIFIC ARTICLES Stomatologija, Baltic Dental and Maxillofacial Journal, 17: 102-4, 2015 Trichoadenoma of the upper lip Gian Paolo Bombeccari, Gianpaolo Guzzi, Umberto Mariani, Andrea Gianatti, Diego Ruffoni, Franco Santoro, Francesco Spadari SUMMARY Background. Trichoadenoma of Nikolowski, who describe the first cases in 1958, is a rare and benign tumor of the hair follicle. It is well-differentiated and slowly-growing. The clinical appearance of Trichoadenoma (TA) can be similar to basal cell carcinoma or epidermal cyst. Results. We describe a 44-year-old male who was referred for nodular lesion on the upper lip and a TA was diagnosed. Oral examination showed exophytic yellow mass located between mucous membrane of the upper lip and vestibular gingiva, 1.2 per 0.8 cm. Anamnestic data was non-contributory. An excisional biopsy of the lesion was performed. Microscopically, the lesion consisted of multiple keratinous cysts lined with stratified squamous epithelium and intermingled with solid islands of basaloid cells lying within sclerotic stroma. The pathological diagnosis was TA. The surgical wound healed uneventfully. Conclusion. Because the lesion is unique, it is uncertain how aggressive or indolent the tumor might be. Therefore, the microscopical analysis is mandatory. At the best of our knowledge, this is the second case of trichoadenoma of the lip. Keywords: lip lesion, oral nodule, lip tumor, oral tumor, oral follicular hamartoma. INTRODUCTION Trichoadenoma (TA) is a rare benign tumor of than trichofolliculoma and is more differentiated the hair follicle, which was first described in 1958 by than trichoepithelioma (4). It is often apparent a dif- Nikolowsky as “organoid follicular hamartoma” (1). -
Desmoplastic Trichoepithelioma: a Clinicopathological Study of Three Cases and a Review of the Literature
2468 ONCOLOGY LETTERS 10: 2468-2476, 2015 Desmoplastic trichoepithelioma: A clinicopathological study of three cases and a review of the literature QIONGYU WANG1, DEEPAK GHIMIRE1, JUAN WANG1, SUJU LUO2, ZHENGXIAO LI1, HAO WANG1, SONGMEI GENG1, SHENGXIANG XIAO1 and YAN ZHENG1 1Department of Dermatology, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi; 2Department of Dermatology, Tianjin Hospital of Tianjin Medical University, Tianjin, P.R. China Received March 13, 2014; Accepted December 3, 2014 DOI: 10.3892/ol.2015.3517 Abstract. Desmoplastic trichoepithelioma (DTE) is a rare are recognized, namely, solitary TE, multiple TE and desmo- benign adnexal tumor with the characteristic features of asymp- plastic TE (DTE) (1). DTE is a rare benign adnexal tumor that tomatic, solitary, annular, indurated and centrally depressed is derived from basal cells in the outer root sheath of the hair papules or plaques, most commonly occurring in younger follicle. The tumor occurs at an incidence of 1 in 5,000 skin individuals on the face. Microscopically and clinically, DTE biopsies in adults, and is usually observed in middle-aged may be difficult to distinguish from other cutaneous adnexal females, but has been reported in all age groups and genders. neoplasms, particularly syringoma, cutaneous metastatic breast DTE usually presents as an asymptomatic, flesh-colored, cancer, morpheaform basal cell carcinoma and microcystic solitary, annular, indurated and centrally depressed papule adnexal carcinoma. The present study reports three cases of or plaque (2,3). The most commonly affected areas are the DTE. The first case was of a 45‑year‑old male with an asymp- sun-exposed areas, particularly facial areas such as the cheeks, tomatic flesh‑colored plaque below the right edge of the outer chin and forehead; less commonly, the tumors may be local- canthus that had been present for seven years. -
Desmoplastic Trichoepithelioma: Report of a Case Illustrating Its Natural History
Desmoplastic Trichoepithelioma: Report of a Case Illustrating Its Natural History James M. Shehan, MD; Christopher J. Huerter, MD First described more than 30 years ago, desmo- The natural history of desmoplastic trichoepi- plastic trichoepithelioma is a rare but benign thelioma is well-defined. Based on the histories of adnexal neoplasm. Most often identified in middle- affected patients, the tumor often slowly expands aged individuals and females, desmoplastic over years and even decades.3 We present a case trichoepithelioma usually is a solitary annular of desmoplastic trichoepithelioma that uniquely plaque. Though the tumors are benign, the pos- documents this progression over time in annual sibility of malignant neoplasm may spark both school photographs. clinical and histologic concern. A full-thickness skin biopsy is advisable when desmoplastic Case Report trichoepithelioma is suspected. A patient’s clini- A 29-year-old woman presented postpartum for cal history may provide some clues to help guide evaluation of changing melanocytic nevi and was diagnosis, as the tumors may be present for years incidentally noted to have a concerning lesion on and slow growth is commonly reported. We pre- her mid left cheek. She reported that the lesion sent a patient with desmoplastic trichoepithelioma had slowly expanded over time and recalled first that uniquely documents and supports the typical being aware of its presence 24 years earlier while natural history of this tumor, as demonstrated by in kindergarten. annual school photographs. Physical examination revealed a 0.831.2-cm, Cutis. 2008;81:236-238. firm, annular plaque with central depression on the mid left cheek (Figure 1).