• Archives of Plastic Surgery
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• v.35 no.1
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• pp.107-109
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• 2008

Purpose: Desmoplastic trichilemmoma is a rare variant of trichilemmoma. Histologically, it has a typical characteristic of trichilemmoma with epithelium of central portion and dense fibrous interstitium. There are only 4 reported cases of desmoplastic trichilemmoma arised in a nevus sebaceus, so we present a case of desmoplastic trichilemmoma arised in a nevus sebaceus with literature review.Methods: A 46-year-old female was clinically diagnosed as nevus sebaceous on left side of the forehead. Considering the facial contour, the mass was totally excised elliptically and direct closure was feasible with undermining subcutaneous layer.Results: Pathology report confirmed desmoplastic trichilemmoma developed from a nevus sebaceus and all tumor margins were negative. There were no evidences of tumor recurrence after surgical treatment.Conclusion: Desmoplastic trichilemmoma developed from a nevus sebaceus is a very rare tumor. Variant tumors can be developed from nevus sebaceus, so surgeon should be cautious in excising the mass totally and confirm the final pathology report.

• Archives of Plastic Surgery
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• v.38 no.6
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• pp.883-885
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• 2011

Purpose: Nevus sebaceus is a congenital hamartomatous lesion, typically involving head and neck. Various benign and malignant neoplasms can develop in association with nevus sebaceus. We report a case of simultaneous occurrence of squamous cell carcinoma and basal cell carcinoma in nevus sebaceus. Methods: A 73-year-old man presented with erythematous to black verrucous nodules on the right subauricular area. The upper part was accompanied with inflammation and ulceration, and no specific findings suspicious for malignant degeneration were found in the lower part preoperatively. The mass was totally excised and the defect was directly closed. Lymph nodes were not involved on concomitant neck dissection. Results: Histopathologic examination confirmed the presence of squamous cell carcinoma in the upper part and basal cell carcinoma in the lower part of a nevus sebaceus. Negative margins were achieved on resection. No clinical problems were found during the 3-month follow-up period. Conclusion: We experienced a rare case of simultaneous occurrence of squamous cell carcinoma and basal cell carcinoma within the same nevus sebaceus. Because patients with nevus sebaceus have risk of malignant changes, surgical excision and work-up for recurrence and metastasis should be considered in suspicious cases. And even in a totally asymptomatic case, the possibility of occult secondary cancer should be informed before surgery in aged patients.

• Archives of Craniofacial Surgery
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• v.18 no.1
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• pp.46-49
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• 2017

Nevus sebaceus is a hamartoma of the sebaceous gland that occurs congenitally, from which various secondary tumors can arise with a prevalence of 5%-6%. Benign neoplasms commonly arise from nevus sebaceous, but they have a very low malignant potential. Two neoplasms may occasionally arise within the same lesion, but it is rare for three or more neoplasms to occur in a nevus sebaceus simultaneously. A 61-year-old male patient was admitted to our hospital for a $4cm\times2.5cm$ growing tumor in a verrucous form arising within a periauricular nevus sebaceus in the post auricle of the left ear that had developed 30 years earlier. The nodule was diagnosed as 3 different types of tumors: trichilemmoma, desmoplastic trichilemmoma, and basal cell carcinoma. To our knowledge, this is the first report of the coexistence of three different tumors arising from nevus sebaceous. It contain malignant neoplasm also. Surgeons should be aware of the need for close monitoring and early complete surgical excision of sebaceous nevus in order to improve patient outcomes.