Saçlı Deride Osseöz Metaplazi: Olgu Sunumu

Abstract

Trikilemmal kistler, sıklıkla yanlış teşhis edilen, saç matrisi hücrelerinden türeyen iyi huylu cilt neoplazmalarıdır. Trikilemmal kistler kalsifikasyon ve ossifikasyon gösterebilir fakat ossifikasyon nadirdir. 50 yaşında bir kadın hastada, kafa derisinden kaynaklanan osseöz metaplazili bir trikelemmal kist vakasını sunmayı planladık. Hasta, saçlı deride ele gelen lezyon sebebiyle genel cerrahi poliklniiğine başvuruda bulundu. Muayenede, hastanın oksipital kafa derisinin sağ tarafında, çıkıntılı sertleşmiş yaklaşık 1,5 x 1 cm'lik bir kistik lezyon mevcuttu. Kitle sertti, hassas değildi ve hasta yaklalık 6 aydır mevcut olduğunu ifade etmekteydi. Sebase kist öntanısı klinik olarak konuldu ve hasta lokal anestezi altında eksizyon için hazırlandı. 15 x 10 x 6 mm boyutlarındaki derialtından çıkarılan lezyon histolojiye gönderildi. Patolojik tanı, rüptüre trikelemmal kist ve osseöz metaplazi ile uyumlu olarak değerlendirildi. Hasta işlem günü taburcu edildi. Postoperatif 10.günde hastanın surturleri alındı. Yara yeri komplikasyonu gözlenmedi. Saçlı deride sebase kist sıklıkla karşımıza çıkan bir patolojik bulgu olmakla birlikte ayırıcı tanıda tanısı zor olmakla birlikte osseöz metaplazi düşünülmelidir.

Keywords

• saçlı deri
• osseöz metaplazi
• trikilemmal kist

Osseous Metaplasia in the Scalp: A Case Report

Abstract

Trichilemmal cysts are benign skin neoplasms derived from hair matrix cells that are frequently misdiagnosed. Trichilemmal cysts may show calcification and ossification, but ossification is rare. We planned to present a case of trichilemmal cyst with osseous metaplasia originating from the scalp in a 50-year-old female patient. The patient applied to the general surgery clinic due to a palpable lesion on the scalp. On examination, there was a protruding, indurated cystic lesion measuring approximately 1.5 x 1 cm on the right side of the patient's occipital scalp. The mass was hard, nontender, and the patient stated that it had been present for approximately 6 months. A preliminary diagnosis of sebaceous cyst was made clinically and the patient was prepared for excision under local anesthesia. The subcutaneous lesion measuring 15 x 10 x 6 mm was sent for histology. The pathological diagnosis was evaluated as compatible with ruptured trichilemmal cyst and osseous metaplasia. The patient was discharged on the day of the procedure. The patient's sutures were taken on the 10th postoperative day. No wound complications were observed. Sebaceous cyst on the scalp is a frequently encountered pathological finding, and although it is difficult to diagnose, osseous metaplasia should be considered in the differential diagnosis.

Keywords

• scalp
• osseous metaplasia
• trichilemmal cyst

References

1. Civatte J, Tsoïtis G, Le Roux P. Perforating ossified (trichilemmal) “sebaceous” cyst. Apropos of a case. Ann Dermatol Syphiligr (Paris). 1974;101:155– 170.
2. Dündar MA, Varsak YK, Kozacioğlu S, Arbağ H. Giant trichilemmal cyst of the submental region. J Craniofac Surg. 2014;25(6):2257-2259. doi:10.1097/ SCS.0000000000001068
3. Fletcher CD. Calcifying and ossifying soft tissue lesions presenting in the skin. J Cutan Pathol. 1996;23(4):297. doi:10.1111/j.1600-0560.1996.tb01300.x
4. Fulton RA, Smith GD, Thomson J. Bone formation in a cutaneous pyogenic granuloma. Br J Dermatol. 1980;102(3):351-352. doi:10.1111/j.1365-2133.1980.tb08153.x
5. Hanau D, Grosshans E. Trichilemmal cyst with intrinsic parietal sebaceous and apocrine structures. Clin Exp Dermatol. 1980;5(3):351-355. doi:10.1111/j.1365-2230.1980.tb01714.x
6. Iqbal B, Putenparampil RA, Kambale T, Dharwadkar A, Viswanathan V. Calcifying epithelioma of Malherbe - a rare localization. Pol J Pathol. 2023;74(4):286-288. doi:10.5114/pjp.2023.134028
7. Kiel CM, Homøe P. Corrigendum: Giant, Bleeding, and Ulcerating Proliferating Trichilemmal Cyst, With Delayed Treatment Due to Coronavirus Outbreak: A Case Report and Review of the Literature. Front Surg. 2022;9:865956. Published 2022 May 11. doi:10.3389/fsurg.2022.865956
8. Leppard BJ, Sanderson KV. The natural history of trichilemmal cysts. Br J Dermatol. 1976;94(4):379-390. doi:10.1111/j.1365-2133.1976.tb06115.x

9. Leyendecker P, de Cambourg G, Mahé A, Imperiale A, Blondet C. 18F-FDG PET/CT Findings in a Patient With a Proliferating Trichilemmal Cyst. Clin Nucl Med. 2015;40(7):598-599. doi:10.1097/RLU.0000000000000742
10. Regis DM, Cunha JLS, Sánchez-Romero C, da Cruz Ramos MAC, de Albuquerque RLC, Bezerra BT. Diagnosis, management, and follow-up of extensive dermoid cyst of the submental region. Autops Case Rep. 2019;9(3):e2019095. Published 2019 Jul 12. doi:10.4322/acr.2019.095