Ahmad Abdullah, Salman Fawaz M, Jeragh Faisal, Dashti Yousef
Department of Ophthalmology, Al-Bahar Ophthalmology Center, Ibn Sina Hospital, Kuwait.
Department of Ophthalmology, Al-Bahar Ophthalmology Center, Ibn Sina Hospital, Kuwait.
Int J Surg Case Rep. 2023 Feb;103:107897. doi: 10.1016/j.ijscr.2023.107897. Epub 2023 Jan 13.
Solitary trichoepitheliomas (TE) are benign tumors that are strikingly similar to their malignant counterpart, basal cell carcinoma (BCC).
An 83-year-old man presented with a 10-year history of a right lower lid skin mass initially diagnosed as BCC. Intraoperatively, an excisional biopsy was performed with primary reconstruction of the skin defect and the specimen was submitted for histopathology processing. Eventually, histopathology findings suggested the diagnosis of benign hair follicle tumor. The postoperative results were aesthetically pleasing and the integrity of the lower lid was preserved.
Despite being rare, benign solitary TE are frequently misdiagnosed as malignant BCC, and vice versa. Oculoplastic surgeons face considerable difficulty distinguishing the two pathologies due to their similar clinical and histological pictures. Hence, excisional biopsy should be considered whenever such discrepancy is confronted to avoid the possibility of recurrence or malignant transformation. Furthermore, immunohistochemical staining could increase the accuracy of diagnosis in such unequivocal findings.
Correlation of clinical, dermoscopic and histopathological findings are essential to establish an accurate diagnosis and select the appropriate management. In-depth understanding of eyelid reconstruction principles is mandatory to achieve desirable goals.
孤立性毛发上皮瘤（TE）是一种良性肿瘤，与恶性的基底细胞癌（BCC）极为相似。
一名83岁男性，右下睑皮肤肿物已有10年病史，最初被诊断为基底细胞癌。术中进行了切除活检，并对皮肤缺损进行了一期修复，标本送组织病理学检查。最终，组织病理学结果提示为良性毛囊肿瘤。术后效果美观，下睑完整性得以保留。
尽管良性孤立性毛发上皮瘤罕见，但常被误诊为恶性基底细胞癌，反之亦然。由于两者临床和组织学表现相似，眼整形医生在鉴别这两种病理情况时面临很大困难。因此，遇到这种差异时应考虑切除活检，以避免复发或恶变的可能性。此外，免疫组化染色可提高此类不明确结果诊断的准确性。
临床、皮肤镜和组织病理学检查结果相互关联对于准确诊断和选择合适的治疗方法至关重要。深入了解眼睑重建原则对于实现理想治疗目标必不可少。
