Proliferating trichilemmal cyst (PTC) is an uncommon tumour arising from outer root sheath of hair follicle which frequently present over the scalp as an isolated swelling 1 to 10 cm in size. PTC is assumed to arise from trichilemmal cyst with histological hallmark of trichilemmal keratinisation. Hardly ever, PTC can endure malignant transformation at which point, it is termed as malignant proliferating trichilemmal cyst (MPTC) which has a high chance of metastasis. We report a case of PTC at exceptional site in an elderly female at peri-genital area with later evolution to cutaneous squamous cell carcinoma (SCC) and metastasized to regional lymph nodes. On further exploration an underlying carcinoma cervix was also detected. So PTC served as a clue for cutaneous as well as cervical malignancy.

Keywords: Proliferating Trichilemmal Cyst, Squamous Cell Carcinoma, Metastasis

1. Baptista AP, Silva LGE, Born MC. Proliferating trichilemmal cyst. J Cutan Pathol 1983;10:178.
2. Satyaprakash AK, Sheehan DJ, Sangueza OP. Proliferating Trichilemmal Tumours: A Review of th Literature.Dermatol Surg. 2009; 1102-1108.
3. Brownstein M, Arluk D. Proliferating trichilemmal cyst: a stimulant of squamous cell carcinoma. Cancer. 1981; 48:1207–14.
4. Singh UR. Proliferating trichilemmal cyst: report of two cases, one benign and the other malignant. J Dermatol.2002;29(4):214-20.
5. Sau P, Graham JH, Helwig EB: Proliferating epithelial cysts: Clinicopathological analysis of 96 cases, J Cutan Pathol. 1995;22: 394–406.
6. Yamaguchi J, Irimajiri T, Ohara K. Proliferating trichilemmal cyst arising in the arm of a young woman. Dermatology. 1994;189:90–2.
7. CassarinoDS, Derienzo DP, Barr RJ. Cutaneous squamous cell carcinoma: a comprehensive clinicopathologic classification part two. J Cutan Pathol. 2006;33(4):261-79.
8. Ackerman AB, de Viragh PA, Chongchitnant N: Proliferating follicular cystic neoplasm; in Neoplasms with Follicular Differentiation, Lea and Febinger, Philadelphia, 1993; 551–570.
9. Saida T, Oohara K, Hori Y, Tsuchiya S: Develop-ment of a malignant proliferating trichilemmal cyst in a patient with multiple trichilemmal cysts. 1983;166: 203–208.
10. Wang X, Yang J, Yang W. Multiple proliferating trichilemmal tumors in a middle-aged yellow man. Tumori 2010;96:349-51.

Dr Ghanshyam Verma

Dept. of Dermatology, Venereology and Leprosy,

Indira Gandhi Medical College, Shimla, HP, INDIA

Email: This email address is being protected from spambots. You need JavaScript enabled to view it.