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Introduction <p>Proliferating trichilemmal tumors (PTTs) or Pilar tumors are rare adnexal neoplasms arising from the outer root sheath of hair follicles. Although generally benign, they may present with clinical features suggestive of malignancy.</p> Case Report <p>We present a 68-year-old woman with a five-year history of an ulcerated, foul-smelling occipital scalp mass and regional lymphadenopathy. Imaging excluded intracranial or calvarial invasion. Histopathology revealed proliferating squamoid cells with abrupt keratinization, dysplasia, and chronic inflammation, confirming proliferative pilar tumor. The lesion was excised with wide margins and reconstructed using a rotational scalp flap.</p> Conclusion <p>This case emphasizes the diagnostic overlap between benign and malignant scalp tumors and the importance of complete excision with histopathological evaluation.</p>

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Proliferating Trichilemmal Tumor of the Scalp: A Rare Case with Diagnostic Challenges and Literature Review

  • 期刊论文

  • 发表日期：

    2025年12月22日

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  • Subham Kumar Sinha,
  • Rajat Mohanty

摘要

Introduction

Proliferating trichilemmal tumors (PTTs) or Pilar tumors are rare adnexal neoplasms arising from the outer root sheath of hair follicles. Although generally benign, they may present with clinical features suggestive of malignancy.

Case Report

We present a 68-year-old woman with a five-year history of an ulcerated, foul-smelling occipital scalp mass and regional lymphadenopathy. Imaging excluded intracranial or calvarial invasion. Histopathology revealed proliferating squamoid cells with abrupt keratinization, dysplasia, and chronic inflammation, confirming proliferative pilar tumor. The lesion was excised with wide margins and reconstructed using a rotational scalp flap.

Conclusion

This case emphasizes the diagnostic overlap between benign and malignant scalp tumors and the importance of complete excision with histopathological evaluation.