Hödl S, Smolle J, Scharnagl E
Hautarzt. 1984 Dec;35(12):640-4.
The biological behavior of proliferating trichilemmal cysts is commented on, based on two cases. Two female patients, 71 and 70 years of age, developed solitary monstrous tumours of the scalp in the course of repeatedly recurring trichilemmal cysts. The biological behaviour of both was marked by infiltration of the galea aponeurotica, and in the latter case, invasion of the calvaria and the venous sinuses of the brain with a lethal outcome. Histologically, the differentiation of the cyst walls ranged from pseudoepitheliomatous hyperplasia to areas largely lacking differentiation, indicating a trichilemmal carcinoma. Therefore, a more cautious evaluation of proliferating trichilemmal cysts, commonly underestimated as pseudocarcinomatous, is indicated. The second case in particular shows that on occasion an invasive carcinoma can arise in a trichilemmal cyst. Radical surgery can not only prevent recurrence with loss of differentiation, but also enable a better histological evaluation of the deep-lying tumour tissue.
基于两例病例对增殖性毛鞘囊肿的生物学行为进行了评论。两名女性患者，分别为71岁和70岁，在反复复发的毛鞘囊肿过程中出现了头皮孤立性巨大肿瘤。两者的生物学行为均表现为帽状腱膜浸润，在后一例中，颅骨和脑静脉窦受侵并导致致命后果。组织学上，囊肿壁的分化程度从假上皮瘤样增生到大部分缺乏分化的区域不等，提示为毛鞘癌。因此，对于通常被低估为假癌性的增殖性毛鞘囊肿，需要进行更谨慎的评估。特别是第二例病例表明，毛鞘囊肿有时可发生浸润性癌。根治性手术不仅可以防止分化丧失的复发，还能对深部肿瘤组织进行更好的组织学评估。
