Unravelling Trichilemmal Carcinoma: A Rare Scalp Malignancy with Diagnostic Dilemmas and Its Multifaceted Management
Gokul Ranjeeth D *
Department of General Surgery, Govt. Stanley Medical College, Chennai, Tamilnadu, India.
Monisha J
CRMI, Govt. Stanley Medical College, Chennai, Tamilnadu, India.
Indhumathi Nachiyar N
Department of General Surgery, Govt. Stanley Medical College, Chennai, Tamilnadu, India.
Arun Babu C
Department of General Surgery, Govt. Stanley Medical College, Chennai, Tamilnadu, India.
*Author to whom correspondence should be addressed.
Abstract
Trichilemmal carcinoma is a rare skin adnexal malignancy, with incidence of 0.05%, primarily affecting the elderly in sun-exposed areas, arising from external sheath of hair follicle. We report a 60-year-old male with a scalp swelling initially diagnosed as sebaceous cyst. Swelling with atypical features require high clinical suspicion for diagnosis.Biopsy suggestive of skin adnexal tumour. After wide local excision and double rotation flap reconstruction, the patient showed good recovery. Post operative histopathologic examination confirmed it to be trichelemal carcinoma. Regular follow-up is essential for recurrence or metastasis, although no formal guidelines exist. This case underscores the critical importance of employing a methodical and structured approach in evaluation of swelling to avert potentially adverse outcomes.
Keywords: Trichilemmal carcinoma, wide local excision, double rotation flap, sun-exposed, metastasis