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Proliferating trichilemmal tumor with a malignant spindle cell component
Stephen J Plumb1, Mary Seabury Stone
1Department of Pathology, University of Iowa, Iowa City, IA 52246, USA. stephen-plumb@uiowa.edu
Journal of Cutaneous Pathology
|September 5, 2002
Summary
A rare malignant spindle cell component can arise in proliferating trichilemmal tumors (PTTs). This aggressive neoplasm is associated with widespread metastasis and poor patient outcomes.
Area of Science:
- Dermatopathology
- Oncology
Background:
- Proliferating trichilemmal tumors (PTTs) are rare skin neoplasms originating from the external root sheath.
- PTTs typically affect older women, predominantly on the scalp, and are usually cured by surgical resection.
Observation:
- This report details a PTT in a 54-year-old man that exhibited rapid growth after 3 years of slow progression.
- Histological examination revealed squamous cell lobules and a distinct spindle cell focus with atypical features.
Findings:
- Immunohistochemistry demonstrated spindle cells positive for vimentin and negative for keratin, EMA, and S-100.
- The presence of a malignant spindle cell component within a PTT is exceedingly rare, with only a few cases documented.
Implications:
- Malignant spindle cell PTTs represent a rare but aggressive neoplasm.
- This tumor type has been linked to fatal widespread metastasis, highlighting the need for vigilant monitoring and treatment.