PDF herunterladen
Open Access
CC BY-NC-ND 4.0 · Asian J Neurosurg
DOI: 10.1055/s-0046-1815943
Case Report

Extensive Calvarial Reconstruction for Recurrent Scalp Malignant Proliferating Trichilemmal Tumor: Case Report

Autor*innen

Weitere Informationen
Auch verfügbar auf
  Lizenzen und Reprints

Abstract

Malignant proliferating trichilemmal tumor (MPTT) is a rare cutaneous neoplasm that arises from the external root sheath of the hair follicles, typically affecting sun-exposed areas such as the scalp, neck, and forehead; it is also misdiagnosed due to its resemblance to other skin neoplasms. This report highlights a rare case of a MPTT with repeated local recurrences, despite undergoing wide surgical resections and adjuvant radiotherapy in two different occasions. We present a case of a 42-year-old African − American man diagnosed with a MPTT of the scalp in 2013, which was treated with surgical excision and adjuvant radiotherapy. In the following years, the patient experienced several local recurrences with deeper involvement of the calvarial bone, requiring multiple additional procedures. In 2023, he underwent bifrontal, biparietal, and right temporal craniectomy for complete tumor excision, followed by a second course of radiotherapy and a further scalp reconstruction in early 2024. Subsequent imaging studies revealed no signs of recurrence, and biopsy results confirmed absence of residual tumor. This case exposes an unusually aggressive and treatment-refractory MPPT, which required multiple surgical procedures for wide resection, as well as two complete courses of radiotherapy, to achieve tumor control; these characteristics place this presentation among the most treatment-refractory forms of the disease reported to date. While radiotherapy has been reported as an effective alternative in cases of tumors resistant to surgery, our experience emphasizes the need for a multimodal strategy when recurrence is suspected, whether based on histopathological features or clinical presentation. This underscores the importance of early surgical intervention, multidisciplinary management, and close long-term follow-up in such rare and challenging tumors.

Keywords

scalp - skin neoplasm - disease - calvarial bone

Authors' Contributions

F.A.-M. diagnosed the patient, supervised and contributed to the final version of the manuscript. P.A.V.-A. collected the data and wrote the first draft of the manuscript with the help of M.C.B.-L. and I.A.F.-F. M.C.B.-L. described the images used in the article with the help of I.A.F.-F. and P.A.V.-A. All authors provided critical feedback and contributed to the writing of the manuscript.


Ethical Approval

The study was conducted according to the principles established in the Declaration of Helsinki.


Patients' Consent

Informed consent was obtained from all the participants of the study.




Publikationsverlauf

Artikel online veröffentlicht:
09. Februar 2026

© 2026. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India