Could EMA and cytokeratin 7 be useful in distinguishing tricholemmal carcinoma from clear-cell squamous cell carcinoma? A case series from our department and a brief review of the literature

Tricholemmal carcinoma is a malignant cutaneous adnexal tumor showing outer root sheath differentiation, thought to be the malignant counterpart of trichilemmoma. Although the real existence of tricholemmal carcinoma continues to be a matter of debate, it has been introduced in the recently publishe...

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Bibliographic Details
Published in:Acta histochemica 2019-08, Vol.121 (6), p.765-767
Main Authors: Ricci, Costantino, Dika, Emi, Di Nanni, Doriana Donatella, Zannetti, Guido, Lambertini, Martina, Corti, Barbara
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Carcinoma, Squamous Cell - classification
Carcinoma, Squamous Cell - diagnosis
Carcinoma, Squamous Cell - metabolism
Carcinoma, Squamous Cell - pathology
Clear-cell squamous cell carcinoma
Diagnosis, Differential
E2F6 Transcription Factor - metabolism
Female
Humans
Immunohistochemistry
Keratin-7 - metabolism
Male
Neoplasm Proteins - metabolism
Skin Neoplasms - classification
Skin Neoplasms - diagnosis
Skin Neoplasms - metabolism
Skin Neoplasms - pathology
Tricholemmal carcinoma
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Summary:Tricholemmal carcinoma is a malignant cutaneous adnexal tumor showing outer root sheath differentiation, thought to be the malignant counterpart of trichilemmoma. Although the real existence of tricholemmal carcinoma continues to be a matter of debate, it has been introduced in the recently published 4th edition of World Health Organization classification of skin tumors. Herein, we evaluated whether immunohistochemistry (EMA, CK7, CK5/14, p63, p16, and Ber-EP4) supports tricholemmal carcinoma as a separate entity and whether it could be useful in this differential diagnosis. A total of 9 cases, 3 tricholemmal carcinomas and 6 clear-cell squamous cell carcinomas were evaluated on the basis of histological criteria suggested by the WHO. In our opinion, although these results need to be validated in larger series, they support tricholemmal carcinoma as a separate entity and suggest an immunohistochemical profile (clear-cell squamous cell carcinomas: EMA diffusely positive, CK7 negative; tricholemmal carcinoma: EMA negative, CK7 patchy or moderately positive) that could be useful for this differential diagnosis.
ISSN:0065-1281
1618-0372
DOI:10.1016/j.acthis.2019.06.002