We report a patient with multiple trichoepitheliomas whose biopsy material also 
demonstrated a range of other neoplasms with follicular differentiation, 
including small nodular trichoblastoma, small nodular basal cell carcinoma 
(BCC), and areas resembling infundibulocystic BCC/basaloid follicular hamartoma. 
These were all intimately associated with otherwise typical trichoepitheliomas 
that dominated the microscopic appearances. Peripheral blood and tumor tissues 
of the patient and his 2 daughters, who apparently had a milder phenotype, were 
studied for alterations in the CYLD and PTCH genes, but mutations or loss of 
heterozygosity was not found in either gene. The occurrence of multiple 
follicular neoplasms within a single lesion adds evidence that, although in most 
cases BCC and trichoblastoma are distinct lesions, the 2 neoplasms do encompass 
a morphological spectrum of follicular differentiation, which is probably more 
overtly expressed in syndromic patients.