Local narrow margin excision sequential with modified ALA-PDT for successful treatment of an 86-year-old patient with malignant proliferating trichilemmal tumor.

Malignant proliferating trichilemmal tumor (MPTT) is thought to represent the malignant counterpart of benign proliferative pilar cyst, a lesion originating from the outer hair root sheath. We report a case of an 86-year-old woman with an exophytic nodule containing an ulcerated surface in the temporal region. Histopathologically confirmed MPTT without metastasis, and considering the risk of metastasis and recurrence, we used single local narrow margin excision combined with modified 5-aminolevulinic acid-mediated photodynamic therapy (ALA-PDT). No recurrence of skin lesions was found in the 2-year follow-up after combined therapy. In conclusion, local narrow margin excision sequential with modified ALA-PDT may be a particularly promising and effective treatment option for MPTT.