Giant trichoblastoma of the scalp.

BACKGROUND: Trichoblastoma is a rare and benign adnexial tumor with characteristic histological features. It occurs on any hair folliclebearing location, and usually presents as a solitary lesion most often less than 2 cm in size. Giant trichoblastoma has been rarely reported in the literature. AIM: To report a new case of giant trichoblastoma, misleading for malignancy. CASE REPORT: A 57-year-old woman presented with a 5 cm-solitary asymptomatic nodular lesion of the scalp, of 28 years. It had been previously excised with recurrence and progressive regrowth. On examination, it was a dome-shaped, erythematous, firm, papillomatous, non infiltrated nodule. Full body work up revealed no metastases. Cutaneous biopsy concluded to trichoblastoma but failed to eliminate malignancy. After excision with secondary skin graft, histological examination confirmed the benignity with clear margins. There was no evidence of recurrence after a 5 year-follow-up period. CONCLUSION: This case illustrates a rare clinical variant of trichoblastoma with an unusual important size. This can be misleading for malignancy, but the slowly progressive course of the tumour in our patient, together with histological benignity led to the correct diagnosis. This tumour is considered as a distinct entity by some authors.

[Odontogenic myxoma: About four cases and review of the literature]. / Le myxome odontogénique : étude de quatre cas et revue de la littérature.

OBJECTIVE: Odontogenic myxoma is an uncommon tumor that represent less than 0,5% of all bone tumors and only 3 to 6% of odontogenic tumors. The aim of this article was to catalogue the clinical cases diagnosed microscopically as odontogenic myxoma and to describe their clinical and radiographic characteristics, comparing these to the data found in the current literature. DESIGN: Histological and immunocytochemical examinations were performed on odontogenic myxomas from four Tunisian patients in a period of 23 years. RESULTS: In the present series, two were male and two female. The age at diagnosis ranged from 19 to 38 years. Three tumors involved the mandible and one occurred in the maxilla. In all cases with radiographic records, lesions presented with a multilocular and osteolytic appearance. Histologically, odontogenic myxomas were mainly composed of spindled or stellate-shaped cells in a mucoid-rich intercellular and alcian blue positive matrix. All cases were treated by tumor-enucleation. There was no evidence of recurrence after 2 to 8 years. CONCLUSION: Clinical and radiological aspects of odontogenic myxomas are not conclusive; a histopathological examination of the lesion is mandatory in order to make the right diagnosis. Because of its high rate of recurrence, surgical treatment through bone resection is the most indicated treatment modality, and the patient must be followed-up closely for years.

[Place of the precocious surgical treatment in facial hemangioma]. / Place du traitement chirurgical précoce dans les hémangiomes périorificiels de la face.

Infantile cutaneous hemangioma is a benign vascular tumour present at 10% of the infants. It forms part of the group of the vascular tumours in the classification of international society for vascular anomalies (ISSVA). Usual surgical attitude is abstention and surgery is proposed only in order to treat sequelae. But some particular situations require early surgery to avoid functional impairment, deformation or growth delay due to the lesion's development. Using our observations, we recall the epidemiology, the physiopathology, the clinical aspects, the particularities of the facial localizations and their treatments. In these localizations the time intervenes like a fourth dimension that is going to modify, to improve or to aggravate the prognosis. Treatment requires a strategy and precocious surgery. We insist on the fact that the dogma of the therapeutic abstention remained true for a majority of children with small size hemangioma and that a precocious surgery must be proposed for some localizations in the face.

B-cell lymphoma of the mandible: a case report.

INTRODUCTION: The mandible is an infrequent localisation of primary osseous non-Hodgkin's lymphomas. Few cases of mandibular non-Hodgkin's lymphomas (NHL) have been reported. CASE REPORT: A rare condition of primary malignant non-Hodgkin's lymphoma of the mandible in 53-year-old man, was reported at the Department of Maxillofacial and Plastic Surgery in Charles Nicolle Hospital (Tunis, Tunisia). Histologic and Immunohistochemical (IHC) examination Confirmed a B-Cell lymphoma. DISCUSSION: The purpose of this report is to describe this rare case of NHL of the mandible, explore the diagnosis and workup, and discuss treatment strategies. In this localisation, neither the clinical features nor the radiologic appearances are often pathognomonic. CONCLUSION: Particular care must be taken to consider lymphoma in the differential diagnosis because this uncommon lesion can pose significant diagnostic problems and is frequently misdiagnosed.

[Primary mucinous carcinoma of the skin. A case report]. / Carcinome mucineux primitif cutané. Une observation.

Primary mucinous carcinoma of the skin is a rare sweat-gland neoplasm with a high recurrence rate. We report a new case of a primary recurrent mucinous carcinoma of the face in a 59-year-old man. Histopathologic examination of the neoplasm showed epithelial islands floating in mucoid material compartmentalized by fibrous septa. Cytokeratin 7, protein S100, estrogen and progesterone receptors were detected at immunohistochemical study, while cytokeratin 20 and actin were undetectable. Histologically, mucinous carcinoma of the skin can be mistaken for a metastasis from extracutaneous sites, particularly the breast or the gastrointestinal tract. Mucinous carcinoma of the skin has a relatively good prognosis with rare distant metastases, but high recurrence rate.

[Malignant transformation of a dermoïd cyst of the scalp. A case report]. / Dégénérescence d'un kyste dermoïde du cuir chevelu. A propos d'un cas.

Dermoïd cysts are benign tumours, resulting of an embryologic defect. They usually have good prognosis, only a single case of malignant transformation of a sublingual dermoid cyst has been brought back in literature. We report a case of carcinomatous transformation of a dermoïd cyst of the scalp, in a 54 years old man.