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Proliferating trichilemmal tumour: diagnostic challenge on core biopsy
  1. Oluyori Kutulola Adegun1,
  2. Simon Morley2,
  3. Nicholas Kalavrezos3 and
  4. Amrita Jay1
  1. 1 Head and Neck Pathology Unit, Histopathology, University College London Hospitals, NHS Foundation Trust, London, UK
  2. 2 Radiology (Imaging), University College London Hospitals, NHS Foundation Trust, London, UK
  3. 3 Head and Neck Cancer Centre, University College London Hospitals, NHS Foundation Trust, London, UK
  1. Correspondence to Dr Oluyori Kutulola Adegun, o.k.adegun{at}


A 70-year-old woman presented with a 10-month history of an irregular mass in the left lateral nape of her neck which had recently increased in size rapidly. Ultrasound-guided core needle biopsy was obtained, and the tumour was diagnosed as a well-differentiated squamous cell carcinoma. Further imaging studies failed to demonstrate additional malignant characteristics. In view of these findings, a wide local excision of the tumour was performed. Histopathological assessment of the resected tumour revealed a proliferating trichilemmal tumour with well-differentiated features and smooth invasion front. This article serves as an important reminder of the challenges associated with pathological evaluation of core needle biopsies of adnexal tumours. It emphasises the importance of clinical-radiological-pathological correlation preferably in a multidisciplinary team setting prior to agreeing on a definitive management plan.

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  • Patient consent for publication Obtained.

  • Contributors NK was involved in the surgical management of the patient and contributed to drafting the case report. SM was involved in the interpretation of the imaging investigations (MRI and CT) and drafting of the case report. OKA and AJ were both involved in pathological assessment of the lesion, establishing a definitive diagnosis, coordinating and preparation of the final manuscript draft. NK, SM and AJ gave final approval for submission of the draft case report.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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