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<p>Malignant proliferating trichilemmal tumour (MPTT) is a rare adnexal neoplasm with less than 100 cases reported in literature. They originate from the outer root sheath of hair follicles typically from scalp commonly in elderly women. Involvement of the plantar sole is exceedingly rare due to limited hair follicle density. Management is primarily surgical but achieving adequate margins in anatomically constrained areas may necessitate adjuvant therapy. We report the case of a 45-year-old male with a painful nodular lesion on the plantar aspect of the left foot located at the base of the 2nd and 3rd toes. Excision of the lesion included wide lateral margins; however, deeper clearance was constrained by the underlying metatarsal bones. Histopathology confirmed MPTT with a close deep margin of 1 mm. As further re-excision was not feasible, adjuvant radiotherapy was advised. At 3 months follow-up, no recurrence or metastasis was observed. MPTT of the plantar sole is exceedingly rare and poses diagnostic and therapeutic challenges. If surgical margins cannot be widened due to anatomical limitations, adjuvant radiotherapy may be considered to reduce the risk of local recurrence but efficacy has not been definitively established.</p>

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Malignant Proliferating Trichilemmal Tumour Arising in Plantar Glabrous Skin: A Rare Case Report

  • 期刊论文

  • 发表日期：

    2026年2月12日

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  • Tushar M. Parmeshwar,
  • Nynasindhu Akula,
  • Reshmi Sultana,
  • Gunvanti Rathod,
  • Samarth Sahoo

摘要

Malignant proliferating trichilemmal tumour (MPTT) is a rare adnexal neoplasm with less than 100 cases reported in literature. They originate from the outer root sheath of hair follicles typically from scalp commonly in elderly women. Involvement of the plantar sole is exceedingly rare due to limited hair follicle density. Management is primarily surgical but achieving adequate margins in anatomically constrained areas may necessitate adjuvant therapy. We report the case of a 45-year-old male with a painful nodular lesion on the plantar aspect of the left foot located at the base of the 2nd and 3rd toes. Excision of the lesion included wide lateral margins; however, deeper clearance was constrained by the underlying metatarsal bones. Histopathology confirmed MPTT with a close deep margin of 1 mm. As further re-excision was not feasible, adjuvant radiotherapy was advised. At 3 months follow-up, no recurrence or metastasis was observed. MPTT of the plantar sole is exceedingly rare and poses diagnostic and therapeutic challenges. If surgical margins cannot be widened due to anatomical limitations, adjuvant radiotherapy may be considered to reduce the risk of local recurrence but efficacy has not been definitively established.