Eyelid skin trichilemmoma and underlying local malignancy: is an aggressive treatment necessary?
| Autor: | Christine A Putri, Jennifer H Y Tan, Hardeep Singh Mudhar, Adam Meeney |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Eyelid Skin Malignancy 030207 dermatology & venereal diseases 03 medical and health sciences 0302 clinical medicine lcsh:Ophthalmology medicine Basal cell carcinoma skin and connective tissue diseases Original Research Trichilemmoma integumentary system business.industry Retrospective cohort study medicine.disease Dermatology Ophthalmology neoplasia medicine.anatomical_structure lcsh:RE1-994 030221 ophthalmology & optometry eyelids Papilloma Eyelid Differential diagnosis business |
| Zdroj: | BMJ Open Ophthalmology BMJ Open Ophthalmology, Vol 5, Iss 1 (2020) |
| ISSN: | 2397-3269 |
| Popis: | ObjectiveTrichilemmoma is a benign tumour derived from the outer root sheath of hair follicles. Trichilemmoma can be associated with basal cell carcinoma (BCC), either as a collision lesion or from malignant transformation. This study evaluates malignancy associated with eyelid trichilemmoma and principles of treatment.Methods and analysisRetrospective study involving biopsy-proven eyelid trichilemmoma cases over 14 years encountered at a tertiary referral centre. Presenting features, differential diagnosis, type and number of operations required and histopathological features including coexisting BCC were analysed.ResultsWe identified 36 cases with an average age of 66 years. The clinical differential diagnoses were mainly BCC (44%), papilloma (36%) and squamous cell carcinoma (SCC) (3%). Three patients (8%) had trichilemmoma with associated BCC. Of the 19 cases (53%) of trichilemmomas without BCC with equivocal surgical margins, seven patients (19%) opted for further excision while 12 patients (33%) opted for observation and were discharged. A patient re-presented two years later with invasive BCC. Overall, 11% of our biopsy-proven eyelid trichilemmoma cases were associated with BCC.ConclusionPatients should be informed that a proportion of incompletely excised eyelid trichilemmomas may conceal underlying BCC. Therefore, further surgery to achieve clear surgical margins should be offered. Patients who opt for observation should be offered 6-monthly follow-up for three to five years. Alternatively, they can be discharged with advice to report any recurrence of lumps, skin changes or loss of lashes at the site of previous lesion. |
| Databáze: | OpenAIRE |
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