毛膜癌(TC)是一种罕见的,低档,附件恶性肿瘤。它通常小于3厘米长,起源于毛囊的外部根鞘,最常见的是身体暴露在阳光下的区域。选择的治疗方法是无肿瘤边缘的广泛局部切除。我们介绍了一位88岁的男性患者,他出现了一个偶然的大,干,在他的头皮上熏蒸肿块一年,需要手术切除。质量,最初被认为是良性皮脂腺囊肿,是根据肿块的组织病理学特征诊断出的12厘米的毛膜癌。样本由角质材料和坏死碎片组成。可行的肿瘤与非典型鳞状增生一致。第一次接触时,肿块被完全切除到头皮,没有留下进一步的组织切除。患者头皮部位保持清洁,无出血或复发。目前,毛管癌的发病率越来越高。该病的病理生理学尚不清楚。由于其位置和分布,来自太阳的辐射是导致病变生长的因素之一。由于p53缺失,三囊囊肿也可以转化为恶性三囊癌。尽管其组织学具有侵略性,但TC具有非侵略性。预后通常良好,因为它具有低转移潜力,比如皮肤鳞状细胞癌.然而,有转移的TC预后差,在治疗上还没有达成共识。对于非转移性TC,具有足够(0.5-1厘米)切缘的简单手术切除是一种有效的治疗方法。不同的研究使用不同的边缘,对于切缘切除的测量没有共识。建议定期随访,但需要进一步研究随访时间表.此外,尽管在恶性TC病例中常用化疗,只有有限数量的研究探索了这种治疗方法.鉴于这种疾病的发病率越来越高,我们强烈建议更多的研究来解决这个知识差距。
Trichilemmal carcinoma (TC) is a rare, low-grade, malignant adnexal tumor. It is usually less than 3 cm long and arises from the external root sheath of the hair follicle, most commonly in sun-exposed areas of the body. The treatment of choice is wide local excision with tumor-free margins. We present an 88-year-old male patient who presented with an incidental large, dry, fumigating mass on his scalp for a one-year duration requiring surgical excision. The mass, initially thought to be a benign sebaceous cyst, was a 12-cm trichilemmal carcinoma diagnosed based on the histopathologic features of the mass. The specimen was composed of keratinaceous material and necrotic debris. The viable tumor was consistent with atypical squamous proliferation. The mass was fully excised down to the scalp on the first encounter, leaving no further tissue to excise. The patient\'s scalp site remained clean and without bleeding or recurrence. Currently, there is an increasing incidence of trichilemmal carcinoma. The pathophysiology of this disease is still unclear. The radiation from the sun is one of the factors that causes the growth of the lesions due to its location and distribution. Trichilemmal cysts can also transform into malignant trichilemmal carcinomas due to the p53 deletion. TC has a non-aggressive course despite its aggressive histology. The prognosis is generally good as it has low metastatic potential, like cutaneous squamous cell carcinoma. However, TC with metastasis has a poor prognosis, and there is no consensus yet on treatment. For non-metastatic TC, simple surgical excision with adequate (0.5-1 cm) margins is an effective treatment. Different studies use different margins, and there is no consensus on the measurement for margin excision. Regular follow-up is recommended, but further studies regarding follow-up schedules are needed. Furthermore, despite the common use of chemotherapy in cases of malignant TC, only a limited number of studies have explored this treatment approach. Given the increasing incidence of the disease, we highly recommend more research to address this knowledge gap.