TRICHILEMMAL CARCINOMA OF THE SCALP: A CLINICAL AND HISTOPATHOLOGICAL DIAGNOSTIC CHALLENGE

Trichilemmal carcinoma is a rare malignant cutaneous adnexal tumor whose clinical presentation may mimic squamous cell carcinoma. We report the case of an 83-year-old woman presenting with a nodular and exophytic lesion of the midline parietal scalp that had progressively evolved over nine months. The clinical appearance was highly suggestive of a malignant skin tumor. An initial biopsy suggested a malignant proliferating trichilemmal tumor. Complete oncologic excision was performed with intraoperative assessment of the deep plane and immediate reconstruction using a rotation flap. Definitive histopathological examination confirmed trichilemmal carcinoma with clear surgical margins. The postoperative course was favorable, with no recurrence at one-year follow-up. This case highlights the clinical diagnostic difficulty associated with this rare tumor and the importance of histopathological examination in establishing the definitive diagnosis.