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Multifocal Malignant Proliferating Trichilemmal Tumour: A Diagnostic Imitator Beyond the Scalp

Author

Listed:
  • Dr. Manika Alexander

    (K H Patil Institute of medical sciences Gagag)

  • Dr. Divyashree

    (K H Patil Institute of medical sciences Gagag)

  • Dr. B. P Bommanahalli

    (K H Patil Institute of medical sciences Gagag)

Abstract

Malignant proliferating trichilemmal tumour (MPTT) is a rare cutaneous adnexal neoplasm arising from the outer root sheath of the hair follicle and represents malignant transformation of a proliferating trichilemmal tumour. It accounts for less than 0.1% of cutaneous malignancies and most commonly presents as a solitary scalp lesion in elderly women. A 60-year-old male presented with progressively enlarging painful swellings over the scalp and left scapular region. Histopathological examination revealed a dermal epithelial tumour showing marked cytological atypia with abrupt trichilemmal keratinization. Periodic acid–Schiff staining demonstrated diastase-resistant cytoplasmic positivity. Immunohistochemistry showed focal CD34 expression with strong nuclear p53 and increased Ki-67 labeling index. The findings were diagnostic of malignant proliferating trichilemmal tumour. Multifocal involvement occurring in a male patient is exceedingly rare. Recognition of trichilemmal keratinization and the use of histochemical and immunohistochemical markers are essential to distinguish MPTT from squamous cell carcinoma and guide appropriate management.

Suggested Citation

  • Dr. Manika Alexander & Dr. Divyashree & Dr. B. P Bommanahalli, 2026. "Multifocal Malignant Proliferating Trichilemmal Tumour: A Diagnostic Imitator Beyond the Scalp," International Journal of Research and Innovation in Applied Science, International Journal of Research and Innovation in Applied Science (IJRIAS), vol. 11(2), pages 1177-1182, February.
    • Handle: RePEc:bjf:journl:v:11:y:2026:i:2:p:1177-1182
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