Laffay Lisa, Depaepe Lauriane, d'Hombres Anne, Balme Brigitte, Thomas Luc, De Bari Berardino
Department of Radiotherapy-Oncology, Centre Hospitalier Lyon-Sud, Pierre Bénite cedex, France.
Tumori. 2012 Mar-Apr;98(2):46e-49e. doi: 10.1700/1088.11948.
Trichoblastic carcinoma (or malignant trichoblastoma) is a rare malignant cancer of adnexal structures with morphological features that in some cases are reminiscent of a trichoblastoma. Trichoblastic carcinoma is underdiagnosed as it is a rather recent entity which is still not recognized as such by all pathologists. The differential diagnosis with basal cell carcinoma is often difficult to make and the optimal treatment has not yet been established.
We report the case of a 43-year-old patient who underwent surgical excision and adjuvant radiotherapy for a growing mass of 40 × 48 mm located in the lumbar right paraspinal skin. The pathological findings demonstrated a trichoblastic carcinoma. The clinicopathological profile, the histogenesis, and the difficulties related to the histopathological diagnosis and treatment of this rare entity are discussed in this article.
Although the published reports on this disease are few, surgery should be considered the standard therapeutic approach for trichoblastic carcinomas. Selected cases presenting clinical features of local aggressiveness can safely be treated with adjuvant irradiation to improve local control. However, acute and particularly late toxicities need to be taken into account in the decision.
毛发母细胞瘤（或恶性毛发母细胞瘤）是一种罕见的附属器结构恶性肿瘤，其形态学特征在某些情况下使人联想到毛发母细胞瘤。毛发母细胞瘤的诊断不足，因为它是一个较新的实体，并非所有病理学家都能识别。与基底细胞癌的鉴别诊断通常很难做出，最佳治疗方法尚未确定。
我们报告了一例43岁患者，该患者因位于右腰背部皮肤的一个40×48mm不断增大的肿块接受了手术切除及辅助放疗。病理结果显示为毛发母细胞瘤。本文讨论了该罕见实体的临床病理特征、组织发生以及与组织病理学诊断和治疗相关的困难。
尽管关于这种疾病的已发表报告很少，但手术应被视为毛发母细胞瘤的标准治疗方法。具有局部侵袭性临床特征的特定病例可以安全地接受辅助放疗以改善局部控制。然而，在做决定时需要考虑急性毒性，尤其是晚期毒性。
