Journal of Foot and Ankle Surgery (Asia Pacific)

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VOLUME 11 , ISSUE 3 ( July-September, 2024 ) > List of Articles

CASE REPORT

Sole Surprises—An Atypical Encounter with Pilar Cyst in the Foot: A Case Report

Vivek M Sodhai, Arjun K Unnam, Sandeep A Patwardhan, Parag K Sancheti

Keywords : Case report, Cystic lesion foot, Excision biopsy, Hemangiovenous malformation, Pilar cyst, Trichilemmal cyst

Citation Information : Sodhai VM, Unnam AK, Patwardhan SA, Sancheti PK. Sole Surprises—An Atypical Encounter with Pilar Cyst in the Foot: A Case Report. J Foot Ankle Surg Asia-Pacific 2024; 11 (3):152-155.

DOI: 10.5005/jp-journals-10040-1349

License: CC BY-NC 4.0

Published Online: 03-07-2024

Copyright Statement:  Copyright © 2024; The Author(s).


Abstract

Aim and background: Pilar cysts in the foot are uncommon occurrences and pose diagnostic challenges, as they are difficult to distinguish from other cystic lesions through both clinical examination and radiological imaging. Consequently, surgical excision is often deemed necessary for definitive diagnosis and treatment. Case description: A 12-year-old female presented with persistent right foot pain subsequent to a glass prick injury. Ultrasonography (USG) of the foot suggested an infective collection, while magnetic resonance imaging (MRI) revealed a well-lobulated lesion along the plantar aspect of the 3rd and 4th toes, initially indicative of a posttraumatic collection or hemangiovenous malformation. Excision biopsy was performed, and histopathological examination revealed a classical pilar cyst with the cyst wall lined by keratinizing squamous epithelium. Conclusion: Pilar cysts in the foot are exceptionally rare and can mimic foreign body granulomas or arteriovenous (AV) malformations. Surgical excision emerges as the preferred treatment for symptomatic cases, emphasizing the significance of accurate diagnosis and intervention. Clinical significance: Persistent foot pain subsequent to a glass prick injury warrants thorough investigation, including consideration of foreign body granuloma or pilar cyst. This case underscores the need for surgical intervention in such cases to rule out uncommon but significant pathologies and provide appropriate treatment.


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  1. Pinkus H. “Sebaceous cysts” are trichilemmal cysts. Arch Dermatol 1969;99:544–555. DOI: 10.1001/archderm.1969.01610230036008
  2. James WD, Berger TG, Elston DM. Andrews’ Diseases of the Skin: Clinical dermatology, 11th edition. Philadelphia, Pennsylvania, United States: Elsevier Inc.; 2011. pp. 668–669.
  3. Kirkham N. Tumors and cysts of the epidermis. In: Elder DE, Elenitsas R, Johnson BL Jr, Murphy GF, Xu X (Eds). Lever's Histopathology of the Skin, 10th edition. Philadelphia, Pennsylvania, United States: Lippincott Williams & Wilkins; 2009. pp. 801–803.
  4. Melikoglu C, Eren F, Keklik B, et al. Trichilemmal cyst of the third fingertip: a case report. Hand Surg 2004;19:131–133. DOI: 10.1142/S0218810414720113
  5. El Hassani Y, Beaulieu JY, Tschanz E, et al. Proliferating trichilemmal tumor of the pulp of a finger: case report and review of the literature. Chir Main 2013;32:117–119. DOI: 10.1016/j.main.2013.02.002
  6. Chandrasekaran V, Parkash S, Raghuveer CV. Epidermal cysts—a clinicopathological and biochemical study. Postgrad Med J 1980;56:823–827. DOI: 10.1136/pgmj.56.662.823
  7. Ikegami T, Kameyama M, Orikasa H, et al. Trichilemmal cyst in the pulp of the index finger: a case report. Hand Surg 2003;8:253–255. DOI: 10.1142/s0218810403001765
  8. Perez LM, Bruce JW, Murrah VA. Trichilemmal cyst of the upper lip. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1997;84:58–60. DOI: 10.1016/s1079-2104(97)90296-1
  9. Lee SJ, Choi KH, Han JH, et al. Malignant proliferating trichilemmal tumor of the lower eyelid. Ophthalmic Plast Reconstr Surg 2005;21:349–352. DOI: 10.1097/01.iop.0000167787.91245.f6
  10. Madan S, Joshi R. Trichilemmal cyst of the penis in a paediatric patient. Sultan Qaboos Univ Med J 2015;15:e129–e132. PMID: 25685373.
  11. Brownstein MH, Arluk DJ. Proliferating trichilemmal cyst: a simulant of squamous cell carcinoma. Cancer 1981;48:1207–1214. DOI: 10.1002/1097-0142(19810901)48:5<1207::aid-cncr2820480526>3.0.co;2-1
  12. Ramaswamy AS, Manjunatha HK, Sunilkumar B, et al. Morphological spectrum of pilar cysts. N Am J Med Sci 2013;5:124–128. DOI: 10.4103/1947-2714.107532
  13. Kaddu S, Requena L. Malignant tumors with follicular differentiation. In: Le Boit PE, Burg G, Weedon D, Sarasin A (Eds). Pathology and Genetics of Skin Tumors. Lyon: IARC press; 2006. pp. 149–151.
  14. Rutty GN, Richman PI, Laing JH. Malignant change in trichilemmal cysts: a study of cell proliferation and DNA content. Histopathology 1992;21:465–468. DOI: 10.1111/j.1365-2559.1992.tb00432.x
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