Giant solitary trichoepithelioma

Bhavuray Teli; P. B. Thrishuli; R. Santhosh; D. N. Amar; Shravan Rajpurohit

doi:10.4103/2278-330X.149951

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Review Article

04 (

); 041-044

doi:

10.4103/2278-330X.149951

Giant solitary trichoepithelioma

Bhavuray Teli^1,, P. B. Thrishuli², R. Santhosh¹, D. N. Amar³, Shravan Rajpurohit¹

1 Department of Surgery, DMWIMS, Wayanad, Kerala

2 Department of Surgery, JSS Medical College and Hospital, Mysore

3 Department of Surgery, Srinivasa Institute of Medical Science, Mangalore, Karnataka

*Corresponding author: Dr. Bhavuray Teli. teli.bhavu@gmail.com

Published: 2020-12-31

MedIntel Services Pvt Ltd. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/.)

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Abstract

Adnexal tumors like giant solitary trichoepitheliomas are uncommon to most of us to permit a ready familiarity with them. Information regarding the genesis, clinical profile, behavior, and management options for this tumor is limited. There are 18 cases reported in the world literature till date. This review attempts to provide insight to this rare tumor. Our search included indexed literature from Pubmed, Directory of Open Access Journals, Health Inter Network Access to Research Initiative and Google databases in addition to standard dermatology texts. Giant solitary trichoepithelioma is a rare trichogenic tumor with potential for local recurrence. It has predilection for the older age, but may present at any age including at birth. It has close resemblance to basal cell carcinoma and other skin adnexal tumors - clinically, cytologically, and histologically. CD10, CD 34, PHLDA1 but not p75NTR are useful adjunct markers. Surgical excision is the standard treatment. Recurrence and possible transformation into BCC cautions follow up at regular intervals.

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References

Anderson DE, Howell JB. Epithelioma adenoides cysticum: Genetic update. Br J Dermatol 1976;95:225-32.
Lever WF. Histopathology of skin, 4 th ed. Philadelphia: J.B. Lippincott Company; 1967. p. 557.
Montgomery H. Dermatopathology, Vol. 2. New York: Hoeber Medical Division, Harper and Row Publishers; 1967. p. 887.
Pinkus H. Premalignant fibroepithelial tumors of skin. AMA Arch Derm Syphilol 1953;67:598-615.
Ohnishi T, Watanabe S. Immunohistochemical analysis of cytokeratin expression in various trichogenic tumors. Am J Dermatopathol 1999;21:337-43.
Mandal AK, Mandal A. Exocrine differentiation of trichoepithelioma and desmoplastic trichoepithelioma: A scanning electron microscopic study. Indian J Pathol Microbiol 1993;36:101-3.
Rosen LB. A review and proposed new classification of benign acquired neoplasms with hair follicle differentiation. Am J Dermatopathol 1990;12:496-516.
Martinez CA, Priolli DG, Piovesan H, Waisberg J. Nonsolitary giant perianal trichoepithelioma with malignant transformation into basal cell carcinoma: Report of a case and review of the literature. Dis Colon Rectum 2004;47:773-7.
Czernobilsky B. Giant solitary trichoepithelioma. Arch Dermatol 1972;105:587-8.
Dvir E. Solitary trichoepithelioma in a 70-year-old man. Arch Dermatol 1981;117:455-6.
Filho GB, Toppa NH, Miranda D, Matos MP, da Silva AL. Giant Solitary Trichoepithelioma. Arch Dermatol 1984;120:797-8.
Tatnall FM, Jones EW. Giant solitary trichoepitheliomas located in the perianal area: A report of three cases. Br J Dermatol 1986;115:91-9.
Beck S, Cotton DW. Recurrent Solitary Giant Trichoepithelioma located in the perianal area: A case report. Br J Dermatol 1988;118:563-6.
Oursin C, Krüger HJ, Sigmund G, Hellerich U. MR imaging of a giant solitary trichoepithelioma of the skin. Radiologe 1991;31:574-6.
Lorenzo MJ, Yebra-Pimentel MT, Peteiro C, Toribio J. Cystic giant solitary trichoepithelioma. Am J Dermatpathol 1992;14:155-60.
Jemec B, Lovgreen Nielsen P, Jemec GB, Balsev E. Giant solitary trichoepithelioma. Dermatol Online J 1999;5:1.
Kazakov DV, Michal M. Trichoepithelioma with giant and multinucleated neoplastic epithelial cells. Am J Dermatopathol 2006;28:63-4.
Fraoua Abdelmoula F, Lahmar Boufaroua A, Goutallier C, Khalfallah MT, Mzabi Regaya S. An uncommon trichoepithelioma: The giant solitary trichoepithelioma. Tunis Med 2006;84:503-5.
Hanumanthiah HC. Radiosurgical ablation of solitary trichoepithelioma. J Cutan Aesthet Surg 2008;1:27-8.
Patrocinio LG, Damasceno PG, Patrocinio TG, Patrocinio JA. Solitary nasal Trichoepithelioma. Rev Bras Otorrinolaringol 2008;74:637.
Krishnamurthy J, Divya KN. The cytology of giant solitary trichoepitheliomas. J Cytol 2010;27:99-101.
Goyal S, Mahajan NC, Garg M, Goyal S. Giant solitary nodular trichoepithelioma: A case report and review of literature. Arch Clin Exp Surg 2012;1:58-60.
Bedir R, Pergel A, Gucer H. Giant solitary trichoepithelioma: A Case report. [Article in Turkish] Dicle Med J 2013;40:137-40.
Colenje E. Tumours of the skin appendages. In: Burns T, Breathnach S, Cox N, Griffiths C, editors. Rook′s Textbook of Dermatology, 8 th ed. Vol. 3. West Sussex: Wiley-Blackwell Publishing; 2010.
Kim C, Kovich OI, Dosik J. Brooke Spiegler syndrome. Dermatol Online J 2007;13:10.
Yong LJ, Jin KD, Ho K, Sung-No J. Trichoepithelioma arising from facial scar tissue. J Craniofac Surg 2013;24:292-4.
Duparc A, Lasek-Duriez A, Wiart T, Duban-Bedu B, Gosset P, Modiano P. Multiple familial trichoepithelioma: A new CYLD gene mutation. Ann Dermatol Venereol 2013;140:274-7.
Michaelsson G, Olsson E, Westermark P. The Rombo syndrome: A familial disorder with vermiculate atrophoderma, milia, hypotrichosis, trichoepitheliomas, basal cell carcinomas and peripheral vasodilation with cyanosis. Acta Derm Venereol 1981;61:497-503.
Kirby JS, Siebert Lucking SM, Billingsley EM. Trichoblastic carcinoma associated with multiple familial trichoepithelioma. Dermatol Surg 2012;38:2018-21.
Gray HR, Helwig EB. Epithelioma adenoides cysticum and solitary trichoepithelioma. Arch Dermatol 1963;87:102-14.
Gilks CB, Clement PB, Woods WS. Trichoblastic fibroma. Am J Dermatopathol 1989;11:397-402.
Sahin MT, Demir MA, Kaya Y, Can M, Inanir I, Oztürkcan S. Inguinal keratotic Basal cell carcinoma mimicking giant solitary trichoepithelioma. J Dermatol 2003;30:395-9.
Elder D, Elenitsas R, Ragsdale BD. Tumors of the epidermal appendages. In: Elder D, Elenitsas R, Jaworsky C, Johnson Jr B, editors. Lever′s Histopathology of the Skin. Philadelphia: Lippincott-Raven; 1997. p. 747-803.
Ho VC. Benign epithelial tumors. In: Freedberg IM, Eisen AZ, Wolff K, Austen KF, Goldsmith LA, Katz SI, editors. Dermatology in General Medicine. New York: McGraw-Hill; 1999. p. 873-914.
David E Elder, Rosalie Elenitsas, Adam I Rubin, Michal loffreda, Jeffrey Miller, O Fred Miller III. Atlas and Synopsis of Lever′s Histopathology of the Skin. Chapter 6, Tumors and Cyst of epidermis and subcutis. 3 rd ed. Philadelphia: Lippincott-Raven; 2012. p. 364.
Rosai J. Rosai and Ackerman′s surgical pathology. 9 th ed. St Louis: Mosby; 2004. p. 176.
Sellheyer K, Cribier B, Nelson P, Kutzner H, Rütten A. Basaloid tumors in nevus sebaceus revisited: The follicular stem cell marker PHLDA1 (TDAG51) indicates that most are basal cell carcinomas and not trichoblastomas. J Cutan Pathol 2013;40:455-62.
Kirchmann TT, Prieto VG, Smoller BR. CD34 staining pattern distinguishes basal cell carcinoma from trichoepithelioma. Arch Dermatol 1994;130:589-92.
Sari Aslani F, Akbarzadeh-Jahromi M, Jowkar F. Value of CD10 expression in differentiating cutaneous basal from squamous cell carcinomas and basal cell carcinoma from trichoepithelioma. Iran J Med Sci 2013;38:100-6.
Jedrych J, McNiff JM. Expression of p75 neurotrophin receptor in desmoplastic trichoepithelioma, infiltrative basal cell carcinoma, and microcystic adnexal carcinoma. Am J Dermatopathol 2013;35:308-15.

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[1] Anderson DE, Howell JB. Epithelioma adenoides cysticum: Genetic update. Br J Dermatol 1976;95:225-32.

[2] Lever WF. Histopathology of skin, 4 th ed. Philadelphia: J.B. Lippincott Company; 1967. p. 557.

[3] Montgomery H. Dermatopathology, Vol. 2. New York: Hoeber Medical Division, Harper and Row Publishers; 1967. p. 887.

[4] Pinkus H. Premalignant fibroepithelial tumors of skin. AMA Arch Derm Syphilol 1953;67:598-615.

[5] Ohnishi T, Watanabe S. Immunohistochemical analysis of cytokeratin expression in various trichogenic tumors. Am J Dermatopathol 1999;21:337-43.

[6] Mandal AK, Mandal A. Exocrine differentiation of trichoepithelioma and desmoplastic trichoepithelioma: A scanning electron microscopic study. Indian J Pathol Microbiol 1993;36:101-3.

[7] Rosen LB. A review and proposed new classification of benign acquired neoplasms with hair follicle differentiation. Am J Dermatopathol 1990;12:496-516.

[8] Martinez CA, Priolli DG, Piovesan H, Waisberg J. Nonsolitary giant perianal trichoepithelioma with malignant transformation into basal cell carcinoma: Report of a case and review of the literature. Dis Colon Rectum 2004;47:773-7.

[9] Czernobilsky B. Giant solitary trichoepithelioma. Arch Dermatol 1972;105:587-8.

[10] Dvir E. Solitary trichoepithelioma in a 70-year-old man. Arch Dermatol 1981;117:455-6.

[11] Filho GB, Toppa NH, Miranda D, Matos MP, da Silva AL. Giant Solitary Trichoepithelioma. Arch Dermatol 1984;120:797-8.

[12] Tatnall FM, Jones EW. Giant solitary trichoepitheliomas located in the perianal area: A report of three cases. Br J Dermatol 1986;115:91-9.

[13] Beck S, Cotton DW. Recurrent Solitary Giant Trichoepithelioma located in the perianal area: A case report. Br J Dermatol 1988;118:563-6.

[14] Oursin C, Krüger HJ, Sigmund G, Hellerich U. MR imaging of a giant solitary trichoepithelioma of the skin. Radiologe 1991;31:574-6.

[15] Lorenzo MJ, Yebra-Pimentel MT, Peteiro C, Toribio J. Cystic giant solitary trichoepithelioma. Am J Dermatpathol 1992;14:155-60.

[16] Jemec B, Lovgreen Nielsen P, Jemec GB, Balsev E. Giant solitary trichoepithelioma. Dermatol Online J 1999;5:1.

[17] Kazakov DV, Michal M. Trichoepithelioma with giant and multinucleated neoplastic epithelial cells. Am J Dermatopathol 2006;28:63-4.

[18] Fraoua Abdelmoula F, Lahmar Boufaroua A, Goutallier C, Khalfallah MT, Mzabi Regaya S. An uncommon trichoepithelioma: The giant solitary trichoepithelioma. Tunis Med 2006;84:503-5.

[19] Hanumanthiah HC. Radiosurgical ablation of solitary trichoepithelioma. J Cutan Aesthet Surg 2008;1:27-8.

[20] Patrocinio LG, Damasceno PG, Patrocinio TG, Patrocinio JA. Solitary nasal Trichoepithelioma. Rev Bras Otorrinolaringol 2008;74:637.

[21] Krishnamurthy J, Divya KN. The cytology of giant solitary trichoepitheliomas. J Cytol 2010;27:99-101.

[22] Goyal S, Mahajan NC, Garg M, Goyal S. Giant solitary nodular trichoepithelioma: A case report and review of literature. Arch Clin Exp Surg 2012;1:58-60.

[23] Bedir R, Pergel A, Gucer H. Giant solitary trichoepithelioma: A Case report. [Article in Turkish] Dicle Med J 2013;40:137-40.

[24] Colenje E. Tumours of the skin appendages. In: Burns T, Breathnach S, Cox N, Griffiths C, editors. Rook′s Textbook of Dermatology, 8 th ed. Vol. 3. West Sussex: Wiley-Blackwell Publishing; 2010.

[25] Kim C, Kovich OI, Dosik J. Brooke Spiegler syndrome. Dermatol Online J 2007;13:10.

[26] Yong LJ, Jin KD, Ho K, Sung-No J. Trichoepithelioma arising from facial scar tissue. J Craniofac Surg 2013;24:292-4.

[27] Duparc A, Lasek-Duriez A, Wiart T, Duban-Bedu B, Gosset P, Modiano P. Multiple familial trichoepithelioma: A new CYLD gene mutation. Ann Dermatol Venereol 2013;140:274-7.

[28] Michaelsson G, Olsson E, Westermark P. The Rombo syndrome: A familial disorder with vermiculate atrophoderma, milia, hypotrichosis, trichoepitheliomas, basal cell carcinomas and peripheral vasodilation with cyanosis. Acta Derm Venereol 1981;61:497-503.

[29] Kirby JS, Siebert Lucking SM, Billingsley EM. Trichoblastic carcinoma associated with multiple familial trichoepithelioma. Dermatol Surg 2012;38:2018-21.

[30] Gray HR, Helwig EB. Epithelioma adenoides cysticum and solitary trichoepithelioma. Arch Dermatol 1963;87:102-14.

[31] Gilks CB, Clement PB, Woods WS. Trichoblastic fibroma. Am J Dermatopathol 1989;11:397-402.

[32] Sahin MT, Demir MA, Kaya Y, Can M, Inanir I, Oztürkcan S. Inguinal keratotic Basal cell carcinoma mimicking giant solitary trichoepithelioma. J Dermatol 2003;30:395-9.

[33] Elder D, Elenitsas R, Ragsdale BD. Tumors of the epidermal appendages. In: Elder D, Elenitsas R, Jaworsky C, Johnson Jr B, editors. Lever′s Histopathology of the Skin. Philadelphia: Lippincott-Raven; 1997. p. 747-803.

[34] Ho VC. Benign epithelial tumors. In: Freedberg IM, Eisen AZ, Wolff K, Austen KF, Goldsmith LA, Katz SI, editors. Dermatology in General Medicine. New York: McGraw-Hill; 1999. p. 873-914.

[35] David E Elder, Rosalie Elenitsas, Adam I Rubin, Michal loffreda, Jeffrey Miller, O Fred Miller III. Atlas and Synopsis of Lever′s Histopathology of the Skin. Chapter 6, Tumors and Cyst of epidermis and subcutis. 3 rd ed. Philadelphia: Lippincott-Raven; 2012. p. 364.

[36] Rosai J. Rosai and Ackerman′s surgical pathology. 9 th ed. St Louis: Mosby; 2004. p. 176.

[37] Sellheyer K, Cribier B, Nelson P, Kutzner H, Rütten A. Basaloid tumors in nevus sebaceus revisited: The follicular stem cell marker PHLDA1 (TDAG51) indicates that most are basal cell carcinomas and not trichoblastomas. J Cutan Pathol 2013;40:455-62.

[38] Kirchmann TT, Prieto VG, Smoller BR. CD34 staining pattern distinguishes basal cell carcinoma from trichoepithelioma. Arch Dermatol 1994;130:589-92.

[39] Sari Aslani F, Akbarzadeh-Jahromi M, Jowkar F. Value of CD10 expression in differentiating cutaneous basal from squamous cell carcinomas and basal cell carcinoma from trichoepithelioma. Iran J Med Sci 2013;38:100-6.

[40] Jedrych J, McNiff JM. Expression of p75 neurotrophin receptor in desmoplastic trichoepithelioma, infiltrative basal cell carcinoma, and microcystic adnexal carcinoma. Am J Dermatopathol 2013;35:308-15.