A large helmet-shaped proliferating trichilemmal tumor of the scalp: Is definitive radiotherapy the treatment? A case report.


Journal

Journal of the Egyptian National Cancer Institute
ISSN: 2589-0409
Titre abrégé: J Egypt Natl Canc Inst
Pays: England
ID NLM: 9424566

Informations de publication

Date de publication:
11 Dec 2019
Historique:
received: 08 08 2019
accepted: 12 11 2019
entrez: 7 5 2020
pubmed: 7 5 2020
medline: 30 10 2020
Statut: epublish

Résumé

Benign proliferating trichilemmal tumors (PTTs) are a rare entity that arises from the outer root sheath of a hair follicle. They range from a benign PTT that recurs locally to the more aggressive malignant PTT that, in addition to recurring locally, has the potential for metastatic spread. However, as a group, PTTs are slow growing and amenable to surgery. To the best of our knowledge, radical radiotherapy without surgery has been used in only one case in an elderly male patient with good oncological and cosmetic results. We present a case of a young unmarried female with a disfiguring PTT of the scalp not amenable to surgery treated successfully with radiotherapy providing good cosmesis. Volumetric modulated arc therapy was used to treat this patient with a dose of 50 Gy in 25 fractions over 5 weeks. A theoretical risk of malignant transformation was explained to the patient. The patient has maintained good cosmesis over the last 12 months with no signs of re-growth. In patients with PTT not amenable to surgery, radiotherapy may be an effective alternative providing local control and good cosmesis.

Sections du résumé

BACKGROUND BACKGROUND
Benign proliferating trichilemmal tumors (PTTs) are a rare entity that arises from the outer root sheath of a hair follicle. They range from a benign PTT that recurs locally to the more aggressive malignant PTT that, in addition to recurring locally, has the potential for metastatic spread. However, as a group, PTTs are slow growing and amenable to surgery. To the best of our knowledge, radical radiotherapy without surgery has been used in only one case in an elderly male patient with good oncological and cosmetic results.
CASE PRESENTATION METHODS
We present a case of a young unmarried female with a disfiguring PTT of the scalp not amenable to surgery treated successfully with radiotherapy providing good cosmesis. Volumetric modulated arc therapy was used to treat this patient with a dose of 50 Gy in 25 fractions over 5 weeks. A theoretical risk of malignant transformation was explained to the patient. The patient has maintained good cosmesis over the last 12 months with no signs of re-growth.
CONCLUSION CONCLUSIONS
In patients with PTT not amenable to surgery, radiotherapy may be an effective alternative providing local control and good cosmesis.

Identifiants

pubmed: 32372190
doi: 10.1186/s43046-019-0007-y
pii: 10.1186/s43046-019-0007-y
doi:

Types de publication

Case Reports Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

7

Auteurs

Haresh Kunhi Parambeth (HK)

Department of Radiation Oncology, All India Institute of Medical Sciences, New Delhi, 110029, India.

Nava Udhayam (N)

Department of Radiation Oncology, All India Institute of Medical Sciences, New Delhi, 110029, India.

Shipra Agarwal (S)

Department of Pathology, All India Institute of Medical Sciences, New Delhi, India.

Subhash Gupta (S)

Department of Radiation Oncology, All India Institute of Medical Sciences, New Delhi, 110029, India.

Prashanth Giridhar (P)

Department of Radiation Oncology, All India Institute of Medical Sciences, New Delhi, 110029, India. prashanth.jipmer@gmail.com.

Gour Kishor Rath (GK)

Department of Radiation Oncology, All India Institute of Medical Sciences, New Delhi, 110029, India.

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