Multiple tumour presentation of trichilemmal carcinoma

Trichilemmal carcinoma is a rare skin tumour occurring in the sun-exposed a reas of the elderly It originates from the external root sheath of the hair follicle and is the malignant form of the trichilemmoma. Clinically, it ma y be mistaken for a squamous cell carcinoma, basal cell carcinoma, nodular melanoma or keratoacanthoma. It is distinct from the proliferating trichile mmal tumour. Trichilemmal carcinoma is usually a solitary lesion and an ext ensive literature search revealed no previously reported cases of multiple tumour presentation. We describe a case of trichilemmal carcinoma arising f rom three distinct sites in the same patient and discuss the differential d iagnoses, histological features and probable aetiology of this rare tumour. (C) 1999 The British Association of Plastic Surgeons.