Trichoptysis

Trichoptysis (rare plural: trichoptyses) is an extremely rare symptom, whereby patients cough up hair. It is highly specific for rupture of a mediastinal teratoma into the tracheobronchial tree, however it is not pathognomonic as several articles claim (see below) . Nevertheless it remains a rare presentation and a productive cough or hemoptysis is much more common.

Trichoptysis is also seen in patients who have had reconstructive surgery of their larynx following treatment for laryngeal carcinoma. The surgical flaps may bear hair-producing cells leading to hair growth within the reconstructed larynx and expectoration of the mature hairs. This is much less common nowadays due to more careful selection of grafts; often skin grafts are only partial thickness for this reason. Also postoperative irradiation might aid in killing the hair follicles.