1/3. Nonsolitary giant perianal trichoepithelioma with malignant transformation into basal cell carcinoma: report of a case and review of the literature.Trichoepitheliomas are benign cutaneous tumors that originate from hair follicles and present in two clinical forms. Multiple trichoepithelioma has autosomal transmission and is dominant as a result of the loss of heterozygosity in the 9p21 region, whereas the giant form is solitary, nonhereditary, and rarely affects the perianal region. Diagnostic differentiation from basal cell carcinoma presents notable difficulty, and the use of immunohistochemical studies often is necessary for correct differentiation. The concomitant presence of giant solitary trichoepithelioma and basal cell carcinoma raises the question of whether there is the possibility of malignant transformation, or if it is simply an encounter between the two types of neoplasia. The objective of the present study was to report on a patient who had the two clinical forms of trichoepithelioma (multiple trichoepithelioma and giant solitary trichoepithelioma) in the perianal region, without hereditary antecedents. In this case, the transformation of the largest-sized lesion into basal cell carcinoma was observed. The lesions were studied by means of histopathologic and immunohistochemical studies to investigate the bcl-2 oncogene. The tissue expression characteristics for bcl-2 and the histopathologic examination allowed the diagnosis of multiple trichoepithelioma in the smaller lesions and nonsolitary giant trichoepithelioma with malignant transformation into basal cell carcinoma in the largest-sized lesion. After surgical excision and adjuvant radiotherapy, the patient is now asymptomatic, without signs of relapse, eight months after the surgery.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
2/3. Two cases of subcutaneous trichoblastoma.This report concerns two Japanese women, 54 and 53 years old, with trichoblastoma. Histopathologically, these neoplasms were mainly composed of follicular germinative cells with fibrotic stroma. One of them was a giant lesion, but the other was small. Because both lesions were located in the subcutis, we termed them subcutaneous trichoblastoma.- - - - - - - - - - ranking = 0.125keywords = giant (Clic here for more details about this article) |
3/3. Trichoepithelioma with giant and multinucleated neoplastic epithelial cells.We report an unusual example of trichoepithelioma containing giant and multinucleated cells in the epithelial compartment. The patient was a 52-year-old woman who presented with a solitary nodule on the scalp measuring 2 cm of apparently long duration. The biopsy revealed a typical trichoepithelioma. The unusual feature was the presence in some epithelial nodules of large epithelial cells with hyperchromatic nuclei and no visible nucleoli that exceed 3 to 5 times the adjacent follicular germinative cells. Often, multinucleated cells were seen. Rare nodules were almost entirely composed of giant/multinucleated cells. The majority of the nodules containing giant cells were situated in the deeper portion of the neoplasm. No mitoses were seen in these giant cells. No enlarged or multinucleated cells were seen in the stroma. The neoplastic epithelial cells were diffusely reactive for bcl-2, including the giant and multinucleated cells. The proliferating rate was low; Ki-67 stained some giant cells. CD34 stained the stroma. We believe that the focal presence of pleomorphic giant cells in trichoepithelioma has no clinical or prognostic implications and does not denote its "malignant transformation".- - - - - - - - - - ranking = 1.375keywords = giant (Clic here for more details about this article) |