Fronek Lisa, Brahs Allyson, Farsi Maheera, Miller Richard
Drs. Fronek, Brahs, and Miller are with HCA Healthcare USF Morsani College of Medicine Largo Medical Center Program in Largo, Florida.
Dr. Farsi is with the Department of Mohs Micrographic Surgery at the University of Florida in Gainesville, Florida.
J Clin Aesthet Dermatol. 2021 Jun;14(6):25-30. Epub 2021 Jun 1.
Trichilemmal carcinoma (TC) is a rare cutaneous tumor thought to be derived from the follicular outer root sheath (ORS). It often manifests as a nondescript skin-colored or pink papule on the hair-bearing, sun-exposed anatomic sites of elderly patients. Trichilemmal carcinoma shows many histologic features reminiscent of follicular ORS-notably, its glycogen-rich clear cells, trichilemmal keratinization, and similar immunostaining profile. Historically, it has been described as following a relatively indolent clinical course, but cases of recurrence, local aggression, and distant metastases have recently been elucidated. Here, we report the case of a 66-year-old male patient who presented with an asymptomatic, erythematous plaque on his neck; biopsy confirmed a diagnosis of TC. The patient deferred Mohs micrographic surgery in favor of wide local excision and was treated successfully with 3-mm margins. Salient histopathologic features, treatment modalities, and management recommendations are discussed.
外毛根鞘癌（TC）是一种罕见的皮肤肿瘤，被认为起源于毛囊外根鞘（ORS）。它常表现为老年患者毛发部位、暴露于阳光下的解剖部位出现的无特征性肤色或粉红色丘疹。外毛根鞘癌具有许多类似于毛囊外根鞘的组织学特征——尤其是其富含糖原的透明细胞、外毛根鞘角化以及相似的免疫染色特征。从历史上看，它被描述为临床病程相对惰性，但最近已明确有复发、局部侵袭和远处转移的病例。在此，我们报告一例66岁男性患者，其颈部出现无症状的红斑性斑块；活检确诊为外毛根鞘癌。该患者推迟了莫氏显微外科手术，选择了广泛局部切除，并以3毫米切缘成功治疗。文中讨论了显著的组织病理学特征、治疗方式及管理建议。
