Dboush Heba G, Al-Doud Mohammad A, Shannaq Ruba Y, Abudarweesh Ishraq S, Jabali Eslam H, Alabbadi Ahmad S
Department of General Surgery, Jordanian Royal Medical Services (JRMS), Amman, Jordan.
Department of Laboratory Medicine and Pathology, Jordanian Royal Medical Services (JRMS), Amman, Jordan.
Int J Surg Case Rep. 2021 Apr;81:105760. doi: 10.1016/j.ijscr.2021.105760. Epub 2021 Mar 14.
Trichilemmal carcinoma is a rare malignant cutaneous adnexal neoplasm of hair follicles originating from the external root sheath epithelium. The diagnosis is rarely made clinically and is still challenging for an experienced pathologist.
To report a rare case of trichilemmal carcinoma presenting as a right axillary mass with regional lymph nodes metastasis and was treated with wide local excision in the General Surgery Department Jordanian Royal Medical Services (JRMS), Jordan.
A 45-year-old presented with a right axillary mass of six-month duration. Physical examination revealed a hyperemic, thickened skin of both armpits with a palpable 5-cm mass in the right axilla. He underwent an excisional biopsy of the right mass. Histopathologic examination revealed a malignant adnexal skin tumour with foci of trichilemmal-type keratinisation. It was excised with adequate margins.
Trichilemmal carcinoma usually occurs on the forehead, scalp, neck, back of hands and trunk. These neoplasms are rare lesions presenting as locally aggressive, low-grade carcinomas and have the potential for nodal involvement and distant metastasis. Therefore, the establishment of a correct diagnosis is vital to guide the treatment plan. Wide excision with adequate tumour-free margins is considered a curative treatment and offers a successful outcome.
Malignant cutaneous adnexal tumours are one of the most challenging subjects of dermatopathology. Surgical excision is always required to establish a definitive diagnosis and differentiation subtypes. Trichilemmal carcinoma is a relatively rare tumour, mainly when located in the axilla.
外毛根鞘癌是一种罕见的起源于毛囊外根鞘上皮的恶性皮肤附属器肿瘤。临床上很少能做出诊断，即使对于经验丰富的病理学家来说诊断也仍然具有挑战性。
报告一例罕见的外毛根鞘癌病例，该病例表现为右侧腋窝肿块并伴有区域淋巴结转移，在约旦皇家医疗服务机构（JRMS）的普通外科接受了广泛局部切除治疗。
一名45岁男性，右侧腋窝肿块已持续六个月。体格检查发现双侧腋窝皮肤充血、增厚，右侧腋窝可触及一个5厘米大小的肿块。他接受了右侧肿块的切除活检。组织病理学检查显示为一种具有外毛根鞘型角化灶的恶性附属器皮肤肿瘤。已将其连同足够的切缘一并切除。
外毛根鞘癌通常发生在前额、头皮、颈部、手背和躯干。这些肿瘤是罕见的病变，表现为局部侵袭性的低级别癌，有发生淋巴结受累和远处转移的可能。因此，做出正确诊断对于指导治疗方案至关重要。广泛切除并保证无瘤切缘被认为是一种根治性治疗方法，且能带来成功的治疗结果。
恶性皮肤附属器肿瘤是皮肤病理学中最具挑战性的课题之一。总是需要通过手术切除来明确诊断并区分亚型。外毛根鞘癌是一种相对罕见的肿瘤，尤其是位于腋窝时。
