Trichilemmal cystis in metastatic melanoma: a case report
The malignant melanoma is a neoplasm associated with a wide variety of cutaneous paraneoplastic syndromes, as dermatomyositis, systemic sclerosis, paraneoplastic pemphigus. We describe a case of four multiple trichilemmal cystis arising on frontal region in the same patient with brain metastasis and...
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| Zitieren: | Trichilemmal cystis in metastatic melanoma: a case report / I. Savarese, M. Grazzini, A. Gori, A. D’Errico, L. Doni, F. Scarfì, P. Covarelli, F. Di Costanzo, V. De Giorgi // Experimental Oncology. — 2017 — Т. 39, № 1. — С. 86-87. — Бібліогр.: 8 назв. — англ. |
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nasplib_isofts_kiev_ua-123456789-1375972025-02-09T22:00:10Z Trichilemmal cystis in metastatic melanoma: a case report Savarese, I. Grazzini, M. Gori, A. D’Errico, A. Doni, L. Scarfì, F. Covarelli, P. Di Costanzo, F. De Giorgi, V. Case report The malignant melanoma is a neoplasm associated with a wide variety of cutaneous paraneoplastic syndromes, as dermatomyositis, systemic sclerosis, paraneoplastic pemphigus. We describe a case of four multiple trichilemmal cystis arising on frontal region in the same patient with brain metastasis and unknown primary melanoma and discuss their relationship. 2017 Article Trichilemmal cystis in metastatic melanoma: a case report / I. Savarese, M. Grazzini, A. Gori, A. D’Errico, L. Doni, F. Scarfì, P. Covarelli, F. Di Costanzo, V. De Giorgi // Experimental Oncology. — 2017 — Т. 39, № 1. — С. 86-87. — Бібліогр.: 8 назв. — англ. 1812-9269 https://nasplib.isofts.kiev.ua/handle/123456789/137597 en Experimental Oncology application/pdf Інститут експериментальної патології, онкології і радіобіології ім. Р.Є. Кавецького НАН України |
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Case report Case report |
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Case report Case report Savarese, I. Grazzini, M. Gori, A. D’Errico, A. Doni, L. Scarfì, F. Covarelli, P. Di Costanzo, F. De Giorgi, V. Trichilemmal cystis in metastatic melanoma: a case report Experimental Oncology |
| description |
The malignant melanoma is a neoplasm associated with a wide variety of cutaneous paraneoplastic syndromes, as dermatomyositis, systemic sclerosis, paraneoplastic pemphigus. We describe a case of four multiple trichilemmal cystis arising on frontal region in the same patient with brain metastasis and unknown primary melanoma and discuss their relationship. |
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Article |
| author |
Savarese, I. Grazzini, M. Gori, A. D’Errico, A. Doni, L. Scarfì, F. Covarelli, P. Di Costanzo, F. De Giorgi, V. |
| author_facet |
Savarese, I. Grazzini, M. Gori, A. D’Errico, A. Doni, L. Scarfì, F. Covarelli, P. Di Costanzo, F. De Giorgi, V. |
| author_sort |
Savarese, I. |
| title |
Trichilemmal cystis in metastatic melanoma: a case report |
| title_short |
Trichilemmal cystis in metastatic melanoma: a case report |
| title_full |
Trichilemmal cystis in metastatic melanoma: a case report |
| title_fullStr |
Trichilemmal cystis in metastatic melanoma: a case report |
| title_full_unstemmed |
Trichilemmal cystis in metastatic melanoma: a case report |
| title_sort |
trichilemmal cystis in metastatic melanoma: a case report |
| publisher |
Інститут експериментальної патології, онкології і радіобіології ім. Р.Є. Кавецького НАН України |
| publishDate |
2017 |
| topic_facet |
Case report |
| url |
https://nasplib.isofts.kiev.ua/handle/123456789/137597 |
| citation_txt |
Trichilemmal cystis in metastatic melanoma: a case report / I. Savarese, M. Grazzini, A. Gori, A. D’Errico, L. Doni, F. Scarfì, P. Covarelli, F. Di Costanzo, V. De Giorgi // Experimental Oncology. — 2017 — Т. 39, № 1. — С. 86-87. — Бібліогр.: 8 назв. — англ. |
| series |
Experimental Oncology |
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2025-12-01T05:15:55Z |
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2025-12-01T05:15:55Z |
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1850281722886750208 |
| fulltext |
86 Experimental Oncology 39, 86–87, 2017 (March)
TRICHILEMMAL CYSTIS IN METASTATIC MELANOMA: A CASE REPORT
I. Savarese1, M. Grazzini1, A. Gori2, A. D’Errico1, L. Doni3, F. Scarfì1, P. Covarelli4, F. Di Costanzo3, V. De Giorgi1, *
1Department of Dermatology, Department of Critical Care Medicine and Surgery, University of Florence,
Firenze 50121, 50132, Italy
2Cancer Research “Attilia Pofferi” Foundation, Pistoia 51100, Italy
3Oncology Unit, Department of Critical Care Medicine and Surgery, University of Florence,
Firenze 50121, 50132, Italy
4Department of Surgery, University of Perugia, Perugia 06121, Italy
The malignant melanoma is a neoplasm associated with a wide variety of cutaneous paraneoplastic syndromes, as dermatomyosi-
tis, systemic sclerosis, paraneoplastic pemphigus. We describe a case of four multiple trichilemmal cystis arising on frontal region
in the same patient with brain metastasis and unknown primary melanoma and discuss their relationship.
Key Words: paraneoplastic syndromes, melanoma, trichilemmal cystis, metastasis.
Skin can be a clue of systemic diseases like malig-
nancy. In paraneoplastic disorders, cutaneous mani-
festations generally take place at a distance from the
primary tumor site. The malignant melanoma is a neo-
plasm associated with a wide variety of cutaneous
paraneoplastic syndromes, as dermatomyositis [1],
systemic sclerosis [2], paraneoplastic pemphigus [3].
We describe a case of four multiple trichilemmal
cystis (TCs) arising on frontal region in the same patient
with brain metastasis and unknown primary melanoma
and discuss their relationship.
In September 2011, a 57-year-old man was re-
ferred to our Department of Dermatology, University
of Flo rence. The previous months, the patient had
a history of neurologic signs (cephalea and left foot
paralysis) evaluated further with instrumental diag-
nostic. Brain CT scan showed an expansive lesion,
43×18 mm of size, in parafalcal frontal region of right
cerebral hemisphere, leading to a complete excision
and confirmation of further malignant melanoma ce-
rebral metastasis. Subsequently patient underwent in-
strumental investigation as digestive endoscopy, brain
magnetic resonance imaging and total body computed
tomography scan for searching the primary melanoma
and/or lymphonodal or visceral metastasis. Neither
primary nor secondary tumor was detected. On clinical
examination, in search of primary melanoma or any cu-
taneous melanoma metastasis, we found 4 pigmented
lesions on the frontal region. The patient has noticed
a recent appearance of these lesions 3 months before
(almost simultaneously with neurological disorders),
but disregarded them. Clinically lesions seemed well-
demarcated, partially indurated, blue nodules, with
a diameter of 2×3 mm each one. On dermoscopical
examination we observed diffuse homogeneous blue-
grey pigmentation (Figure).
Although homogeneous blue pattern on dermo-
scopy is a feature of blue nevus, in this case regarding
anamnesis and sudden eruption, we advanced diag-
nosis of cutaneous melanoma metastasis. All lesions
were excised and histopathologically a final diagnosis
of TCs was done. In November, the patient began head
and neck radiotherapy (30 Gy). Positron emission
tomography scan did not point out any primary and/
or secondary malignancy. On clinical and dermato-
scopic examination, no suspicious lesions or palpable
lymphadenopathy were detectable, so we proposed
a follow-up every 3 months. Nine months after surgery,
no metastasis were found clinically and/or in image
studies.
b
a
c
Figure. A case of TCs in metastatic melanoma: a — clinically,
well-demarcated, round, partially indurated, blue color nodules,
2×3 mm in diameter each, are demonstrated in frontal region;
b — one of four blue nodules is shown; c — on dermoscopical
examination, homogeneous blue-grey diffuse pigmentation, ar-
borizing vessels and solar lentigines around the lesion are visible
We discuss a possible relationship between TCs
and melanoma in a patient with brain metastasis and
unknown primary melanoma.
Submitted: October 04, 2016.
*Correspondence: E-mail: vincenzo.degiorgi@unifi.it
Tel.: 0039-055-6939632;
fax: 0039-055-6939632
Abbreviation used: TCs — trichilemmal cystis.
Exp Oncol 2017
39, 1, 86–87
Experimental Oncology 39, 86–87, 2017 (March) 87
In literature many cutaneous paraneoplastic
syndromes are described in association with mela-
noma [1–3]. In these paraneoplastic disorders, the
skin condition generally is a consequence of cancer,
but is not due to the local presence of cancer cells
as such. According to Curth [4, 5], criteria that define
a paraneoplastic cutaneous syndrome include: (1) de-
velopment of a dermatosis only after the development
of a malignant neoplasm, (2) both the dermatosis and
the malignant neoplasm follow a parallel clinical course,
(3) the condition is not recognized as part of a genetic
syndrome, (4) a specific tumor occurs with a probable
dermatosis, (5) the dermatosis is not common, and
(6) a high percentage of the association is noted. A har-
monized ethiology for paraneoplastic cutaneous mani-
festations is doubtful. It is hypothe sized that mediators
such as growth factors, cytokines, active hormones and
other unidentified mediators by tumor or tumor-induced
antigen-antibody interactions are involved in the patho-
genesis of the cutaneous findings. Among cutaneous
paraneoplastic manifestations, pigmentary disorders
were described in literature [6, 7].
In our case, the fast and sudden eruption of pig-
mented lesions occurred during the period of first neu-
rological signs. No association between TCs and
neoplasm was described in literature. Instead, multiple
trichilemmomas can be associated to neoplasm as mel-
anoma in Cowden syndrome. Trichilemmal (or pylar)
cyst, as trichilemmoma, origins from the “trichilemma”
or the exposed outer root sheath. Clinically TCs appear
as asymptomatic swellings nodules, typically without
visible pores. On dermoscopy, TCs can appear with
homogeneous blue pattern, probably due to keratinous
mass according to Gencoglan et al. [8], and simulate
cutaneous melanoma metastasis.
The temporal relationship of the cutaneous eruption
of TCs with advanced stage of melanoma (TxN0M1c)
in our patient strongly suggests a probable paraneo-
plastic manifestation. While in our case primary mela-
noma is still to be discovered, the mediators released
by melanoma could be implicated in TC onset.
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