Giant solitary trichoepithelioma

Giant solitary trichoepithelioma is a cutaneous condition characterized by a skin lesion that may be up to several centimetres in diameter.

Signs and symptoms
Giant solitary trichoepithelioma primarily affects the perianal and groin region. They typically measure a few centimeters in diameter and rarely reach 2 to 3 cm.

Diagnosis
Giant solitary trichoepithelioma is distinguished histologically by a dermal or subcutaneous tumor made up of basophilic cells grouped in solid, adenoid, or lace-like clusters. The cells have a sparse cytoplasm and a darkly pigmented nucleus, and the tumor islands exhibit the typical peripheral cell palisading. Papillary bodies and trichilemmal keratinization in horn cysts are indicative of a solid diagnosis, however they are not always present. Failures to develop papillary mesenchyme are represented by papillary bodies.

Treatment
The preferred course of treatment is either radiosurgical ablation or surgical excision, with or without a flap.