Multifocal Malignant Proliferating Trichilemmal Tumor: A Diagnostic Imitator Beyond the Scalp

January 2026 in “ International Journal of Research and Innovation in Applied Science ”

Manika Alexander, Dr. Divyashree, Dr. B. P Bommanahalli

malignant proliferating trichilemmal tumour MPTT trichilemmal keratinization CD34 p53 Ki-67 hair follicle outer root sheath skin cancer

TLDR Recognizing specific markers is crucial for correctly diagnosing and treating rare multifocal MPTT in males.

Malignant proliferating trichilemmal tumour (MPTT) is a rare skin cancer originating from the hair follicle's outer root sheath, accounting for less than 0.1% of skin malignancies. It typically appears as a single scalp lesion in elderly women, but this case involved a 60-year-old male with painful swellings on the scalp and left scapular region. Histopathological analysis showed significant cytological atypia and trichilemmal keratinization, with immunohistochemistry revealing CD34 expression, strong nuclear p53, and a high Ki-67 index, confirming MPTT. Multifocal MPTT in males is extremely rare, and recognizing trichilemmal keratinization along with specific markers is crucial for differentiating MPTT from squamous cell carcinoma and ensuring proper treatment.

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