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Annales de Dermatologie et de Vénéréologie
Vol 128, N° 1  - février 2001
p. 35
Doi : AD-01-2001-128-1-0151-9638-101019-ART8
Cas clinique

Fibrome trichoblastique en plaque
 

L. Beguin [1], J.-F. Poulain [1], D. Chatelain [2], J.P. Denoeux [1], C. Lok [1]
[1] Service de Dermatologie et Vénéréologie, CHRU Amiens.
[2] Service d'Anatomie et Cytologie pathologiques, CHRU Amiens.

Abstract
Introduction

Le fibrome trichoblastique est une tumeur folliculaire bénigne rare, qui se présente sous deux formes cliniques : nodulaire et en plaque. Cette distinction se traduit, pour la forme en plaque, par sa topographie touchant presque exclusivement le visage et par une infiltration plus importante des tissus en profondeur.

Observation

Un homme de 38 ans avait, depuis 3 ans, une plaque bien limitée, mesurant 2 cm de diamètre, jaunâtre, d'extension progressive, localisée à la joue droite. Le diagnostic clinique initial était celui de carcinome basocellulaire. L'examen anatomopathologique de l'exérèse complète de la tumeur cutanée permettait de retenir le diagnostic de fibrome trichoblastique. Aucune récidive locale n'était constatée avec un recul de 10 mois.

Commentaires

Le fibrome trichoblastique appartient au groupe des tumeurs trichogénétiques. Altman oppose, sur le plan histologique, à la forme nodulaire bien circonscrite, la forme en plaque, mal limitée latéralement et en profondeur. L'auteur insiste également sur le nombre plus élevé de mitoses dans la forme en plaque, lui conférant un caractère de faible malignité.

Abstract
Plaque variant of trichoblastic fibroma.
Background

Tricoblastic fibroma is a rare benign skin tumor originating in the hair follicle. There are two clinical presentations: nodular and plaque variants. The plaque variant is almost exclusively located on the face with deep tissue infiltration.

Case report

A 38-year-old man presented with a 2 cm diameter cutaneous plaque located on the right cheek. It had first been noted by the patient 3 years earlier and had enlarged slowly. On examination, the plaque was well defined, yellowish and slightly indurated. The first clinical diagnosis was basal cell carcinoma and the plaque was removed. Histology provided the diagnosis of trichoblastic fibroma. The patient remains well, with no evidence of recurrence, 10 months after excision.

Discussion

Trichoblastoma is an inclusive term for all benign cutaneous neoplasms that are mostly composed of follicular germinative cells. According to Altman, the plaque variant of trichoblastic fibroma is a poorly circumscribed neoplasm, particularly at its lateral and deep margins. This author also states that mitotic figures are more numerous in the plaque variant of trichoblastic fibroma and considers this clinical variant as a low-grade follicular malignancy.






© 2001 Elsevier Masson SAS. Tous droits réservés.
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