Proliferating trichilemmal cysts

Case contributed by Rania Adel Anan
Diagnosis almost certain

Presentation

Right frontal non-painful hard swelling.

Patient Data

Age: 65 years
Gender: Female

A well-defined partially calcified ovoid scalp mass is seen at the right frontal region (corresponding to the clinically palpable swelling). Other smaller similar lesions are seen at the right temporal region.

Cavum septum pellucidum & verge (variant).

Involutional brain changes are also noted & manifested by prominent ventricular system, subarachnoid CSF spaces, cortical sulci, basal cisterns and Sylvian fissures.

Case Discussion

CT findings are in keeping with proliferating trichilemmal cysts (also known as pilar cysts).

Proliferating trichilemmal cysts usually arise in the scalp. They have a female predominance.

An epidermal inclusion cyst is the most common lesion to be considered in the differential diagnosis.

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