Arch Craniofac Surg.  2018 Dec;19(4):275-278. 10.7181/acfs.2018.02124.

A giant trichoblastic carcinoma

Affiliations
  • 1Department of Plastic and Reconstructive Surgery, School of Medicine, Kyungpook National University, Daegu, Korea. kychoi@knu.ac.kr

Abstract

Trichoblastic carcinoma usually occurs as a malignant transformation of the trichoblastoma, but is very rare. A 25-year-old man was admitted with trichoblastoma in the nuchal area with frequent recurrences since birth. The preoperative neck magnetic resonance image revealed lobulated soft tissue lesions involving superficial fascia and infiltrating into both proximal trapezius muscles. In our department, wide excision and reconstruction with a free anterolateral thigh flap were performed. Histological examination revealed skin adnexal carcinoma, originating from the hair follicles, consistent with trichoblastic carcinoma. There was no palpable mass 5 years postoperatively, and there was no recurrence on follow-up positron emission tomography-computed tomography. Trichoblastic carcinomas are rare and difficult to diagnose, but histopathological findings include atypical basaloid keratinocytes with crowded, hyperchromatic nuclei, and increased mitotic activity. The presence of hypercellular stroma is a criterion for distinguishing trichoblastic carcinoma from basal cell carcinoma. A rare giant trichoblastic carcinoma was reported, which was the biggest one in the literature.

Keyword

Trichoblastic carcinoma; Cutaneous adnexal tumors; Free anterolateral thigh flap

MeSH Terms

Adult
Carcinoma, Basal Cell
Electrons
Follow-Up Studies
Hair Follicle
Humans
Keratinocytes
Neck
Parturition
Recurrence
Skin
Subcutaneous Tissue
Superficial Back Muscles
Thigh
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