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Abstract
Background. Basal cell carcinoma (BCC) is the most common type of malignant skin tumor with basal cell differentiation. Trichoepithelioma (TE), however, is a rare benign skin tumor with follicular differentiation. Both types of tumor have commonalities in terms of clinical and histopathological features. Some cases, in fact, require ancillary studies to distinguish between the two. Confusing the two tumors may result in different future outcomes for the patient, due to their vastly different prognoses and treatments. This case report outlines two different cases, and discusses how to distinguish between the two types of tumor without the use of an ancillary study.
Method. We examined the cases of one patient with basal cell carcinoma and one patient with trichoepithelioma, comparing their clinical manifestations and characteristic histological features.
Results. Trichoepithelioma and BCC share several overlapping histopathological features. Trichoepithelioma and BCC share several overlapping histopathological features. The TE in this case report also exhibited a nodular pattern, connection to the epidermis, stromal cleft, and prominent nuclear palisading, which are more commonly found in BCC. However, scanty mitotic activity, the presence of non-atypia cells, and symmetry of the lesion, are favor TE.
Conclusion. Differentiation between BCC and TE is only possible using cytomorphological assessment with a high-power field of view.
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References
- Tebcherani, A. J., De Andrade, H. F., & Sotto, M. N. (2012). Diagnostic utility of immunohistochemistry in distinguishing trichoepithelioma and basal cell carcinoma: Evaluation using tissue microarray samples. Modern Pathology, 25(10), 1345–1353. https://doi.org/10.1038/modpathol.2012.96
- Lazaridou, E., Fotiadou, C., Patsatsi, A., Fotiadou, A., Kyrmanidou, E., Kemanetzi, C., & Ionnides, D. (2014). Solitary trichoepithelioma in an 8-year-old child: clinical, dermoscopic and histopathologic findings. Dermatology Practical & Conceptual, April. https://doi.org/10.5826/dpc.0402a11
- Carr, A. V., Feller, E., Zakka, F. R., Griffith, R. C., & Schechter, S. (2018). A Case Report of Basal Cell Carcinoma in a Non-Sun-Exposed Area: A Rare Presentation Mimicking Recurrent Perianal Abscess. Case Reports in Surgery, 2018(Figure 1), 1–5. https://doi.org/10.1155/2018/9021289
- Mohammadi, A. A., & Seyed Jafari, S. M. (2014). Trichoepithelioma: a rare but crucial dermatologic issue. World Journal of Plastic Surgery, 3(2), 142–145. http://www.ncbi.nlm.nih.gov/pubmed/25489539%0Ahttp://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=PMC4236999
- Patterson, J. W. (2021). Basal Cell Carcinoma. In Weedon's Skin Pathology, Fifth Edition (pp. 848–852). Samaka, R., Bakry, O., Seleit, I., Abdelwahed, M., & Hassan, R. (2013). Multiple familial trichoepithelioma with malignant transformation. Indian Journal of Dermatology, 58(5), 409. https://doi.org/10.4103/0019-5154.117348
- Samaka, R., Bakry, O., Seleit, I., Abdelwahed, M., & Hassan, R. (2013). Multiple familial trichoepithelioma with malignant transformation. Indian Journal of Dermatology, 58(5), 409. https://doi.org/10.4103/0019-5154.117348
- Teli, B., Thrishuli, P. B., Santhosh, R., Amar, D. N., & Rajpurohit, S. (2015). Giant solitary trichoepithelioma. South Asian Journal of Cancer, 4(1), 41–44. https://doi.org/10.4103/2278-330X.149951
- Mesina, J., Epstein, E. H. J., Kossard, S., McKenzie, C., Patel, R. ., Patterson, J. ., & Scolyer, R. . (2018). Basal Cell Carcinoma. In WHO Classification of Skin Tumours (pp. 26–34).
References
Tebcherani, A. J., De Andrade, H. F., & Sotto, M. N. (2012). Diagnostic utility of immunohistochemistry in distinguishing trichoepithelioma and basal cell carcinoma: Evaluation using tissue microarray samples. Modern Pathology, 25(10), 1345–1353. https://doi.org/10.1038/modpathol.2012.96
Lazaridou, E., Fotiadou, C., Patsatsi, A., Fotiadou, A., Kyrmanidou, E., Kemanetzi, C., & Ionnides, D. (2014). Solitary trichoepithelioma in an 8-year-old child: clinical, dermoscopic and histopathologic findings. Dermatology Practical & Conceptual, April. https://doi.org/10.5826/dpc.0402a11
Carr, A. V., Feller, E., Zakka, F. R., Griffith, R. C., & Schechter, S. (2018). A Case Report of Basal Cell Carcinoma in a Non-Sun-Exposed Area: A Rare Presentation Mimicking Recurrent Perianal Abscess. Case Reports in Surgery, 2018(Figure 1), 1–5. https://doi.org/10.1155/2018/9021289
Mohammadi, A. A., & Seyed Jafari, S. M. (2014). Trichoepithelioma: a rare but crucial dermatologic issue. World Journal of Plastic Surgery, 3(2), 142–145. http://www.ncbi.nlm.nih.gov/pubmed/25489539%0Ahttp://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=PMC4236999
Patterson, J. W. (2021). Basal Cell Carcinoma. In Weedon's Skin Pathology, Fifth Edition (pp. 848–852). Samaka, R., Bakry, O., Seleit, I., Abdelwahed, M., & Hassan, R. (2013). Multiple familial trichoepithelioma with malignant transformation. Indian Journal of Dermatology, 58(5), 409. https://doi.org/10.4103/0019-5154.117348
Samaka, R., Bakry, O., Seleit, I., Abdelwahed, M., & Hassan, R. (2013). Multiple familial trichoepithelioma with malignant transformation. Indian Journal of Dermatology, 58(5), 409. https://doi.org/10.4103/0019-5154.117348
Teli, B., Thrishuli, P. B., Santhosh, R., Amar, D. N., & Rajpurohit, S. (2015). Giant solitary trichoepithelioma. South Asian Journal of Cancer, 4(1), 41–44. https://doi.org/10.4103/2278-330X.149951
Mesina, J., Epstein, E. H. J., Kossard, S., McKenzie, C., Patel, R. ., Patterson, J. ., & Scolyer, R. . (2018). Basal Cell Carcinoma. In WHO Classification of Skin Tumours (pp. 26–34).