Reconstruction of metachronous cylindroma and trichoblastic carcinoma with forehead flap

Trichoblastic carcinoma (TC) is a rare malignant tumor arising from skin adnexal structures, which usually appears without a progenitor lesion. Few TC cases originating from benign lesions have been reported. This study presents a case of nasal reconstruction with forehead flap of a TC manifesting a decade after the excision of a cylindroma at the identical site. A 64-year-old male presented with a multinodular mass on the right nasal ala, growing for 3 months. Surgical history included a cylindroma excision from the same area 10 years ago. The current lesion was excised and reconstructed with a full-thickness skin graft. After histopathological examination, the patient was diagnosed with TC. Wide re-excision with 7 mm margin and a paramedian forehead flap followed by adjuvant radiotherapy was performed. The patient healed without any complications. In the literature, metachronous presentation of cylindroma and TC has not been reported before. With increasing reports of this disease, it will be possible to understand the disease and form a management consensus.