Faculty, Department of Biotechnology, University of Isfahan, Iran.
Trichoblastic is a slowing growing rare tumor. It is said as a rare hair follicle tumor occurred from a malignant transformatrion of a bengin trichoblastoma. Sun exposing is also a cause to trichoblastic tumor. The tumour arises from follicular germinative cells and develops dermal or subcutaneous fat invasion.
Clinical features of trichoblastic carcinoma
Lesions of trichoblastoma are often found on the face and scalp of adults around 40-50 years aged . If the trichoblastoma has been left untreated, it can undergo malignant transformation into a trichoblastic carcinoma. In some cases, where the first trichoblastoma has been excised, a recurring lesion with high metastatic potential may develop at an equivalent site years later.
Trichoblastic carcinoma tumours have also occurred on other parts of the body including the forearm, lower back and thigh. They have been found in both male and feminine patients aged between 40-90 years aged . Some patients may experience occasional moderate itching and bleeding of the tumour. Tumours could also be locally aggressive and cause widespread metastases within the lymphatic and blood systems. Although rare, there are several cases of trichoblastic carcinoma with widespread metastases and death.
Trichoblastic carcinoma diagnosed
Skin biopsy is that the only definitive diagnosis for trichoblastic carcinoma. Ideally, the entire tumour should be excised and submitted for histological examination. The histology of trichoblastic carcinoma will differentiate it from other skin tumours that have similar clinical presentations, these include its benign counterpart trichoblastoma, trichilemmal carcinoma, pilomatrix carcinoma and basal cell carcinoma.
Histological findings of trichoblastic carcinoma are very almost like those found in basal cell carcinoma. It is extremely important to form the right diagnosis, as basal cell carcinoma rarely metastasise and become life-threatening, whilst trichoblastic carcinoma are often aggressive and cause death.
Treatment of trichoblastic carcinoma
Complete surgical excision with a margin of normal tissue is that the recommended treatment. Mohs micrographic surgery could also be wont to ensure better margin control. Currently there's no consensus regarding the margin size of normal tissue. Additional radiotherapy and/or chemotherapy could also be wont to treat metastases and for locally aggressive tumours.
Prognosis in patients with trichoblastic carcinoma are often poor, especially if initially benign trichoblastoma lesions are present for an extended time and if patients are immunocompromised.