Trichoblastoma D23.L

Author: Prof. Dr. med. Peter Altmeyer

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Last updated on: 02.06.2022

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Fibroma; Fibroma trichoblastic; Fibroma trichogenic; immature; Myxoma; Myxoma trichogenes; Panfolliculoma; trichigenes; trichoblastic; Trichoblastoma; Trichoepithelioma; Trichoepithelioma immature; trichogenic; Trichogenic adnexal tumor

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Benign, biphasic (epithelial-conjunctival), dermal or subcutaneous, solitary but also multiple tumor with follicular germ cell differentiation. They occur as the most frequent secondary neoplasia in the nevus sebaceus.

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According to the currently valid WHO classification, different histological variants of trichoblastoma are distinguished:

  • Large-boned
  • Small Nodules (including adamantinoid)
  • Retiform (solitary giant trichoepithelioma) - very rare variant
  • Cribriform (conventional trichoepithelioma) - most common variant
  • Razemiform (non-conventional trichepithelioma)
  • Columnar (desmoplastic trichoblastoma)

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Occurring at any age. Preference for the 5th to 6th decade of life. The sporadic tumours are predominantly of the female sex (2-5:1).

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Located on the capillitium. Especially frequent in adenoma sebaceum.

Clinical features
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Solitary or multiple, skin-coloured, pigmented, also reddish, firm, 0.5-3.0 cm large, surface-smooth, clinically otherwise completely uncharacteristic nodule. Larger lesions are rather rare.

The diagnosis is usually a histological incidental finding.

Especially the large nodular variant of the trichoblastoma (this finding is probably identical with the "giant trichepithelioma or solitary giant trichoepithelioma") is found as secondary tumor in nevus sebaceus.

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Cutaneous or subcutaneous nodules delimited by a fibrosis zone with different growth patterns: large nodules, small nodules, sieve-like (cribriform), deer antlers (razemous), retiform (reticular). Epithelial nests of monomorphic, basaloid cells, with roundish to oval nuclei. Palisade position of the peripheral cells. Compacted, hyalisized or mucinous stroma; isolated small granulomatous infiltrates. Formation of primitive hair germ structures, also sebaceous gland lobules. Larger lobules may contain cystic cavities in their centres, with amorphous cell debris. Occasional mitoses. Trichoblastomas may have focal pigmentation.

Differential diagnosis
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Excision in the healthy.

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Usually benign tumor of the germ cells of the hair follicle, although aggressive, infiltrative growth is repeatedly described; malignant degeneration may also occur. Excision in sano with incision margin control is recommended. Local recurrence is rare.

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The panfolliculoma is considered a variant of the trichoblastoma.

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  1. Ackerman AB, De Viragh PA, Chongchitnant (1993) Trichoblastoma. In Ackerman AB: (eds) Neoplasms with follicular differentiation. Lea & Febiger, Philadelphia London, pp. 359-422.
  2. Imai et al (1982) Trichogenic trichoblastoma. Dermatologist 33: 609-611
  3. Kaddu S et al (2003) Adnexal tumors with hair follicle differentiation. In: Kerl H et alo. (Eds) Histopathology of the skin. Springer, Berlin Heidelberg New York pp 662-664.
  4. LeBoit PE (2003) Trichoblastoma, basal cell carcinoma, and follicular differentiation: what should we trust? Am J Dermatopathol 25: 260-263
  5. Misago N et al (2002) Sebaceoma and related neoplasms with sebaceous differentiation: a clinicopathologic study of 30 cases. Am J Dermatopathol 24: 294-304.
  6. Requena C et al (2019) Multiple facial plaque variant of trichoblastoma. J Cutan Pathol 46: 285-289.
  7. Walke r B et al. (2021) Invasive Trichoblastoma Treated With Mohs Micrographic Surgery. Dermatologic Surgery: 47: 1275-1276.
  8. Cowen EW et al (2000) An unusually aggressive trichoblastoma. J Am Acad Dermatol. 42:374-377.
  9. Demant M et al (2020) Don't Judge a Tumor by Its Biopsy! Case Rep Dermatol 12: 266-274


Please ask your physician for a reliable diagnosis. This website is only meant as a reference.


Last updated on: 02.06.2022