Brain MRI Appearance of a Scalp Proliferating Trichilemmal Tumor: Case Report
DOI:
https://doi.org/10.54133/ajms.v9i2.2500Keywords:
Brain MRI, Proliferating trichomonal tumor, Trichilemmal cystAbstract
Background: The proliferating trichilemmal tumor is a solid-cystic lesion in the hair follicle's isthmus. Most reported cases of proliferating trichilemmal tumors (PTT) exhibit a benign growth pattern; however, aggressive behavior can occasionally occur, characterized by invasion beyond the cyst wall that simulates squamous cell carcinoma. Additionally, local recurrence and distant metastasis have been observed. Case presentation: A 57-year-old female with a histopathology-proven proliferating trichilemmal tumor presented with a recurrent scalp mass. It was a sizable occipital scalp mass that was ruptured to the skin with purulent discharge and surrounded by cellulitis. A brain MRI was performed, which showed a large mass on the right side of the occipital scalp. The mass was mostly solid and showed an isointense signal on the pre-contrast T1, T2, and FLAIR sequences, with some low-T1 and high-T2 signal intensity cystic areas. Homogenous enhancement of the solid part on post-contrast T1WI was evident, and no diffusion restriction was noted. The calvarium and intracranial extension did not show any gross invasion. In conclusion, imaging findings of proliferating trichilemmal tumors may help differentiate between closely similar lesions. It is also beneficial to evaluate surrounding soft tissue and intracranial extension denoting a malignant transformation.
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