Advanced treatment of giant proliferating trichilemmal tumor: limited resection combined with neoadjuvant ALA-PDT

Wide local excision with a 1cm margin is the standard treatment for proliferating trichilemmal tumor (PTT), but it is challenging to treat giant tumors, or tumors located on the scalp and face. We present a case of a 90-year-old woman with painful PTT on the cheek who was cured by a combination of limited resection and neoadjuvant ALA-PDT. Preoperative and postoperative 20% ALA-PDT was used for a total of 6 sessions. PTT was resected 2 mm outside the clinical margins under local infiltration anesthesia. The PTT with a size of 69 × 59 × 37mm was removed by limited resection. ALA-PDT was an effective therapy for local anti-inflammation and anti-tumor. The old woman received it well and recovered quickly. Limited resection combined with neoadjuvant ALA-PDT is an advanced treatment for giant PTT, which has the advantages of minimally invasive, effective and safe.