title: Extensive and ulcerated malignant proliferating trichilemmal (pilar) tumour, arising from multiple, large, degenerated trichilemmal (pilar) cysts.
abstract: We report a rare case of a 61-year-old homeless man with a 15-year history of multiple trichilemmal cysts that served as a forerunner for the emergence of a malignant proliferating pilar tumour. The patient presented multiple, large, purulent, ulcerated lesions ranging from 10 to 150 mm in diameter, covering most of the scalp, with large areas superimposed by extensive myiasis infestation. The patient presented with no other major clinical findings. A CT scan showed no detectable signs of local or distant metastatic invasion. Initial supportive treatment was implemented. Given the extent of the injury, further surgical excision was considered, which required transfer to a specialised surgical centre. This social case is of educational value, as it can raise clinician awareness about the ability of trichilemmal cysts to undergo malignant transformation. Additionally, it highlights the importance of adequate social assistance structures for patients in need.
authors: Department of Biomedical Sciences and Medicine, University of Algarve, Faro, Algarve, Portugal.
authors: Bruno
authors: B
authors: Morgado
authors: Department of Anatomic Pathology, Hospital Centre of Algarve: Hospital of Barlavento Algarvio, Portimão, Portugal.
authors: Patrick
authors: P
authors: Agostini
authors: Department of General Surgery, Hospital Centre of Algarve: Hospital of Barlavento Algarvio, Portimão, Portugal.
authors: António
authors: A
authors: Rivero
authors: Department of Biomedical Sciences and Medicine, University of Algarve, Faro, Algarve, Portugal.
authors: Nuno
authors: N
authors: Silva
mesh_terms: D004814:Epidermal Cyst / Q000150:complications* / Q000473:pathology; D006258:Head and Neck Neoplasms / Q000209:etiology / Q000473:pathology*; D006703:Ill-Housed Persons; D006801:Humans; D008297:Male; D008875:Middle Aged; D012535:Scalp; D012878:Skin Neoplasms / Q000209:etiology / Q000473:pathology*