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Proliferating trichilemmal cysts

Case contributed by Ismail Kabakus
Diagnosis almost certain

Presentation

Patient with cutaneous malignant melanoma, evaluation for metastases

Patient Data

Age: 65 years
Gender: Male

Multiple partially calcified subcutaneous ovoid masses of the scalp (hair-bearing portion).

Case Discussion

Proliferating trichilemmal cysts, also known as pilar cysts or tumors, are slow-growing lobulated masses most commonly found on the scalp of elderly women. They form from hair follicle. The cysts are smooth, mobile and filled with keratin, a protein component found in hair, nails, and skin. Because of keratin, they have soft tissue density (higher HU values than simple cysts). They may have coarse calcification.

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