Subtle Trichilemmal Carcinoma of Neck Initially Misdiagnosed as Benign Cyst and Ultimately Treated with Mohs Micrographic Surgery Misdiagnosed Trichilemmal Carcinoma of Neck Ultimately Treated with Mohs Micrographic Surgery

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Parastou Mandy Shahzeidi, M.S.
Reed Fezza
William H. Green, M.D.


Trichilemmal Carcinoma, Mohs micrographic surgery, MMS, TC, adnexal neoplasm, pilar cyst, trichilemmal cyst



Trichilemmal carcinoma(TC) is an exceeding rare malignant adnexal lesion, originating from hair follicle cells. Given its rarity, widely variable clinical presentation, and often non-specific appearance, TC is commonly misdiagnosed as a number of different lesions, some benign, which can lead to delays in treatment and suboptimal patient outcomes. In this report, we discuss a 65-year-old man with a neck lesion originally misdiagnosed as benign and later found to be TC all along. We also discuss several treatment options, and ultimately favor Mohs Micrographic Surgery (MMS) as the preferred treatment for TC in this case.


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