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Presented by Peter Illei, M.D. and prepared by Amy Duffield, M.D., Ph.D.
Case 1: 19 y.o. white male patient with a right cheek skin nodule.
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1. Question
Week 376: Case 1
19 y.o. white male patient with a right cheek skin noduleimages/12_15_08 1A.jpg
images/12_15_08 1B.jpg
images/12_15_08 1C.jpg
images/12_15_08 1D.jpg
images/12_15_08 1E.jpgCorrect
Answer: Desmoplastic trichoepithelioma
Histology: The sections show a proliferation of small angulated epitheliel islands and strands of basaloid epithelium with keratinecous cyts formation and associated sclerotic stroma. These demonstrate ductal differentiation, with “tad pole” epithelial extends.
Discussion: This lesion demonstrates overlapping features with syringoma and microcystic adnexal carcinoma, but the process extends and appears to be limited to the lower reticular dermis, favoring desmoplastic trichoepithelioma. A conservative excision with negative surgical margins is the treatment of choice.
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Answer: Desmoplastic trichoepithelioma
Histology: The sections show a proliferation of small angulated epitheliel islands and strands of basaloid epithelium with keratinecous cyts formation and associated sclerotic stroma. These demonstrate ductal differentiation, with “tad pole” epithelial extends.
Discussion: This lesion demonstrates overlapping features with syringoma and microcystic adnexal carcinoma, but the process extends and appears to be limited to the lower reticular dermis, favoring desmoplastic trichoepithelioma. A conservative excision with negative surgical margins is the treatment of choice.