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Tumor Discovery

CASE REPORT
Malignant proliferating trichilemmal tumor

post-chemotherapy: A case report

Bahaa Razem * , Ouail Ilhami 1,2 , Sami El Hamid 1 , Abdelhakim Oukerroum 1,2 ,
1
and Faiçal Slimani 1,2
1 Department of Stomatology and Maxillofacial Surgery, 20 Aout 1953 Hospital, Casablanca, Morocco
2 Department of Medicine, Faculty of Medicine and Pharmacy, Hassan II University, Casablanca, Morocco

Abstract
The malignant proliferating trichilemmal tumor (MPTT) is an exceptional adnexal
neoplasm of the skin, primarily observed in the scalp of elderly women, often
precipitated by local trauma or chronic inflammation. Notably, MPTT exhibits a
propensity for local aggressiveness, frequently leading to diagnostic challenges
reminiscent of squamous cell carcinoma. The primary treatment modality entails
surgical excision with adequate margins, yielding a relatively low local recurrence
rate. Herein, we present the case of a 50-year-old woman diagnosed with MPTT of
the scalp several years subsequent to undergoing chemotherapy for breast cancer,
initially misdiagnosed as squamous cell carcinoma upon biopsy. This case marks only
the third reported instance associating MPTT with chemotherapy following breast
cancer treatment. We aim to draw attention to this particularly aggressive tumor and
its potential origination from benign trichilemmal cysts due to chemotherapy.

Keywords: Malignant proliferating trichilemmal tumor; Trichilemmal cyst; Breast cancer;
*Corresponding author:
Bahaa Razem Chemotherapy
(r.bahaa@hotmail.fr)
Citation: Razem B, Ilhami O, El
Hamid S, Oukerroum A, Slimani F.
Malignant proliferating trichilemmal 1. Background
tumor post-chemotherapy:
A case report. Tumor Discov. Proliferating trichilemmal tumors (PTTs) are a rare entity of adnexal tumors arising
2024;3(2):2344. from the isthmic portion of the outer root sheet of the hair follicle. They represent
1,2
doi: 10.36922/td.2344 only 0.1% of skin tumors. Malignant proliferating trichilemmal tumors (MPTTs), on
1,3
Received: November 30, 2023 the other hand, are even rarer. Their exact incidence is undetermined due to the rarity
Accepted: January 31, 2024 of reported cases in the literature, the absence of case series, and the lack of clinical and
Published Online: May 20, 2024
histological features differentiating them from squamous cell carcinoma. MPTTs appear
Copyright: © 2024 Author(s). to occur mostly in the scalp region of elderly women. They are locally aggressive tumors
This is an Open-Access article
distributed under the terms of the associated with recurrence and even nodal or distant metastatic spread. Herein, we report
Creative Commons Attribution a case of an MPTT of the scalp in a female patient. It marks only the third reported case
License, permitting distribution, of MPTT associated with a history of breast cancer treated by chemotherapy. Through
4,5
and reproduction in any medium,
provided the original work is this case report, we aim to attract the attention of specialists to investigate a potential
properly cited. causal link between chemotherapy and MPTT.
Publisher’s Note: AccScience
Publishing remains neutral with 2. Case presentation
regard to jurisdictional claims in
published maps and institutional A 50-year-old woman was referred to the Maxillofacial Department of our hospital by
affiliations. her oncologist due to a scalp mass. The patient reported that the lesion had been present

Volume 3 Issue 2 (2024) 1 doi: 10.36922/td.2344