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Flanagan KE, Burns LJ, Pathoulas JT, Walker CJ, Pupo Wiss I, Cornejo KM, Senna MM. Primary Alopecia Neoplastica: A Novel Case Report and Literature Review. Skin Appendage Disord 2021; 7:499-509. [PMID: 34901185 DOI: 10.1159/000516650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 02/16/2021] [Indexed: 11/19/2022] Open
Abstract
Alopecia neoplastica (AN) is caused by neoplastic cells damaging hair follicles, resulting in patchy hair loss like cicatricial alopecia and alopecia areata. AN has predominantly described cutaneous metastasis to the scalp from primary visceral malignant tumors. Less frequently, AN results from a primary scalp neoplasm. Compared to "secondary AN," there is a paucity of literature on "primary AN." Herein, we present a comprehensive literature review of primary AN and introduce a unique case of amelanotic melanoma causing primary AN. Including our presented case, 11 cases of primary AN have been reported with causative scalp neoplasms including angiosarcoma, hemangioendothelioma, syringomatous carcinoma, ectopic extramammary Paget's disease, and primary desmoplastic melanoma. 27.3% (3 of 11) of cases were misdiagnosed and treated for a primary alopecia, and 36.4% (4 of 11) of lesions were present for multiple years or an unknown amount of time, likely due to difficulty in recognizing scalp lesion or misdiagnosis. All patients required surgical excision with 36.4% (4 of 11) requiring chemotherapy, radiation, or photodynamic therapy. Two patients with scalp angiosarcoma died from their aggressive disease. Due to the risks of malignant primary AN if allowed to progress, primary AN should be considered in patients presenting with scarring alopecia.
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Affiliation(s)
- Kelly E Flanagan
- Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Laura J Burns
- Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - James T Pathoulas
- Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Chloe J Walker
- Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Isabel Pupo Wiss
- Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Kristine M Cornejo
- Dermatopathology Unit, Massachusetts General Hospital, Boston, Massachusetts, USA.,Harvard Medical School, Boston, Massachusetts, USA
| | - Maryanne M Senna
- Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts, USA.,Harvard Medical School, Boston, Massachusetts, USA
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Sallman MA, Li JY, Swaby M, Chon SY. Cutaneous scalp metastasis of cholangiocarcinoma in hepatitis C. JAAD Case Rep 2020; 6:468-470. [PMID: 32395602 PMCID: PMC7203513 DOI: 10.1016/j.jdcr.2017.01.024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Affiliation(s)
- Mary Alice Sallman
- John P. McGovern Medical School, University of Texas Health Science Center, Houston, Texas
| | - Janet Y Li
- Department of Dermatology, University of Texas Health Science Center, Houston, Texas
| | - Michael Swaby
- Department of Pathology and Laboratory Medicine, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Susan Y Chon
- Department of Dermatology, Division of Internal Medicine, University of Texas MD Anderson Cancer Center, Houston, Texas
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Diop A, Diallo M, Ndiaye MT, Seck B, Diadie S, Diatta BA, Ndiaye M, Baidouri Z, Deme A, Ly F, Niang SO, Kane A, Dieng MT. [Epidemiological and anatomoclinical features of scalp tumors in black Africans]. Pan Afr Med J 2019; 34:98. [PMID: 31934241 PMCID: PMC6945662 DOI: 10.11604/pamj.2019.34.98.18123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Accepted: 08/14/2019] [Indexed: 11/17/2022] Open
Abstract
Introduction Au Sénégal, les études portant sur les tumeurs du cuir chevelu sont quasi inexistantes. Notre objectif était de déterminer le profil épidémiologique et anatomo-clinique des tumeurs du cuir chevelu en dermatologie. Méthodes Il s'agit d'une étude prospective, descriptive et analytique, réalisée sur une période de 16 mois (01 mars 2014 au 30 juin 2015), effectuée aux deux services de dermatologie de Dakar. La confirmation diagnostique était histopathologique. Résultats Nous avions colligé 36 patients dont 14 cas de tumeurs malignes et 22 cas de tumeurs bénignes. Le sex ratio était de 1:1, et l'âge moyen de 51 ans pour les premières et 39 ans pour les dernières. La fréquence hospitalière était de 0,18%. Le délai moyen de consultation était de 14 mois pour les tumeurs malignes et 52 mois pour les formes bénignes. Dans 11 cas de tumeurs malignes, le traitement traditionnel était le premier recours. Les tumeurs malignes étaient: carcinome épidermoïde (n=8), carcinome basocellulaire (n=3), lymphome, hidradénocarcinome et dermatofibrosarcome de Darier Ferrand (un cas chacun). Les tumeurs bénignes étaient: botriomycome (n=5), kyste trichilemmal, hamartome sébacé, cylindrome et lipome (2 cas chacun), et chéloide, syringocystadénome papillifère, schwannome, neurofibrome et nævus (un cas chacun). La malignité de la tumeur était associée à l'aspect ulcéro-bourgeonnant (p=0.003), au diamètre >4cm (p=0.05), à la douleur (p=0.009) et au saignement (p=0.006). Conclusion Les tumeurs du cuir chevelu, sur peau noire, sont dominées par les formes bénignes. Le carcinome épidermoïde est la tumeur maligne prédominante.
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Affiliation(s)
- Assane Diop
- Dermatologie Hôpital Institut d'Hygiène Sociale de Dakar, Université Cheikh Anta Diop de Dakar, Dakar, Sénégal
| | - Moussa Diallo
- Dermatologie Hôpital Aristide Le Dantec, Université Cheikh Anta Diop de Dakar, Dakar, Sénégal
| | - Mame Tene Ndiaye
- Dermatologie Hôpital Institut d'Hygiène Sociale de Dakar, Université Cheikh Anta Diop de Dakar, Dakar, Sénégal
| | - Biram Seck
- Dermatologie Hôpital Institut d'Hygiène Sociale de Dakar, Université Cheikh Anta Diop de Dakar, Dakar, Sénégal
| | - Saer Diadie
- Dermatologie Hôpital Aristide Le Dantec, Université Cheikh Anta Diop de Dakar, Dakar, Sénégal
| | - Boubacar Ahy Diatta
- Dermatologie Hôpital Aristide Le Dantec, Université Cheikh Anta Diop de Dakar, Dakar, Sénégal
| | - Maodo Ndiaye
- Dermatologie Hôpital Aristide Le Dantec, Université Cheikh Anta Diop de Dakar, Dakar, Sénégal
| | - Zineb Baidouri
- Dermatologie Hôpital Institut d'Hygiène Sociale de Dakar, Université Cheikh Anta Diop de Dakar, Dakar, Sénégal
| | - Ahmadou Deme
- Institut Curie Hôpital Aristide Le Dantec, Université Cheikh Anta Diop de Dakar, Dakar, Sénégal
| | - Fatimata Ly
- Dermatologie Hôpital Institut d'Hygiène Sociale de Dakar, Université Cheikh Anta Diop de Dakar, Dakar, Sénégal
| | - Suzanne Oumou Niang
- Dermatologie Hôpital Aristide Le Dantec, Université Cheikh Anta Diop de Dakar, Dakar, Sénégal
| | - Assane Kane
- Dermatologie Hôpital Aristide Le Dantec, Université Cheikh Anta Diop de Dakar, Dakar, Sénégal
| | - Mame Thierno Dieng
- Dermatologie Hôpital Aristide Le Dantec, Université Cheikh Anta Diop de Dakar, Dakar, Sénégal
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Phelan PS, Mull JL, Rajput MZ, Musiek AC. Concurrent metastases of papillary thyroid carcinoma to the scalp and Meckel's cave. BMJ Case Rep 2018; 2018:bcr-2017-222552. [PMID: 29914897 DOI: 10.1136/bcr-2017-222552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
We present the case of a 65-year-old man with severe headaches and unilateral facial weakness, seen in consultation by the dermatology service to rule out primary cutaneous melanoma after brain imaging identified an enlarging mass within the right trigeminal (Meckel's) cave. Examination revealed only a pair of erythematous papules on the scalp, for which biopsy demonstrated metastatic papillary thyroid carcinoma. Further evaluation and subsequent thyroidectomy confirmed the origin of widespread internal disease, followed by definitive excision of scalp lesions and multimodal management of systemic involvement. Whereas presentation of metastasis to the skin is highly variable, a low threshold for biopsy may allow for histological identification of internal disease not otherwise considered in the clinical differential.
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Affiliation(s)
- Patrick S Phelan
- Washington University in Saint Louis School of Medicine, Saint Louis, Missouri, USA
| | - Jamie L Mull
- Division of Dermatology, Washington University in Saint Louis School of Medicine, Saint Louis, Missouri, USA
| | - Mohamed Z Rajput
- Washington University in Saint Louis School of Medicine, Mallinckrodt Institute of Radiology, Saint Louis, Missouri, USA
| | - Amy C Musiek
- Division of Dermatology, Washington University in Saint Louis School of Medicine, Saint Louis, Missouri, USA
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Liu X, Li W, Yuan H, Gu W, Chen D. Surgical treatment of rare giant malignant tumors of the scalp: A report of 3 cases with different tumor types. Oncol Lett 2016; 12:3411-3416. [PMID: 27900013 DOI: 10.3892/ol.2016.5113] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2015] [Accepted: 06/16/2016] [Indexed: 01/17/2023] Open
Abstract
The scalp is the most frequent site of occurrence of malignant tumors. As an area that is generally neglected by the patient and not closely monitored during physical examinations, scalp tumors can go unnoticed until they become malignant. The present study reports 3 cases of rare giant malignant tumors of the scalp, namely a peripheral nerve sheath tumor, a fibrous tumor and a malignant proliferating trichilemmal tumor, that were treated at The First Bethune Hospital of Jilin University (Changchun, China). Vascularized free anterolateral thigh flap surgery was performed in 2 of the 3 cases. A local flap repair was applied to the third case. The implanted skin grafts remained viable post-operatively and wound repair was uneventful. No signs of malignancy were detected on the edge of the pathological section upon closer pathological examination. In the follow-up period, no recurrence was detected in any of the cases.
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Affiliation(s)
- Xiaoliang Liu
- Department of Neurological and Cancer Surgery, The First Bethune Hospital, Jilin University, Changchun, Jilin 130021, P.R. China
| | - Wenzhong Li
- Department of Neurological and Cancer Surgery, The First Bethune Hospital, Jilin University, Changchun, Jilin 130021, P.R. China
| | - Hepei Yuan
- Department of Pathology, The First Bethune Hospital, Jilin University, Changchun, Jilin 130021, P.R. China
| | - Weihong Gu
- Department of Surgery, The Second Bethune Hospital, Jilin University, Changchun, Jilin 130041, P.R. China
| | - Dawei Chen
- Department of Neurological and Cancer Surgery, The First Bethune Hospital, Jilin University, Changchun, Jilin 130021, P.R. China
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