Abstract:
AIMS:Trichoblastic carcinomas (malignant trichoblastomas) are rare and poorly documented neoplasms characterized by malignant transformation of a pre-existing benign trichoblastoma and subdivided histologically into low- and high-grade tumours. While morphologically low-grade trichoblastic carcinomas show an indolent behaviour, the morphologically high-grade variant has been associated with poor prognosis, but little is known about their true biologic potential. The present study aims to better define the clinico-pathological features and outcome of morphologically high-grade trichoblastic carcinomas. METHODS AND RESULTS:Four high-grade trichoblastic carcinomas were retrieved from departmental files and the clinical and histopathological features and follow-up were recorded. The tumours presented as nodules on the scalp, neck and shoulder of adults (median age: 40 years, range: 30-55) with a female predominance of 3:1. Three patients had a longstanding history with recent change. Histologically, three tumours were characterized by an expansile cellular nodule composed of sheets of pleomorphic epithelioid cells with brisk mitotic activity and necrosis arising in a background of a benign trichoblastoma. One tumour displayed a more gradual transition from a benign trichoepithelioma to an undifferentiated carcinoma with an infiltrative growth and perineural infiltration. All patients were alive with no evidence of recurrence or metastasis following complete excision after a median follow-up of 96 months (range: 30-180). CONCLUSIONS:The correct diagnosis of high-grade trichoblastic carcinoma relies on adequate sampling and recognition of the benign trichoblastic precursor lesion, trichoblastoma or trichoepithelioma. Despite the concerning histologic features of the malignant component, the tumours appear to be less aggressive than previously thought.
journal_name
Histopathologyjournal_title
Histopathologyauthors
Mehta A,Davey J,Wiedemeyer K,Brenn Tdoi
10.1111/his.14325subject
Has Abstractpub_date
2021-01-03 00:00:00eissn
0309-0167issn
1365-2559pub_type
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