INTRODUCTION AND BACKGROUND: Albinism is an autosomal recessive disorder characterized by the absence of melanin in the skin, albinism has a prevalence of 1 in 1000 in sub-Saharan Africa, with a lack of melanin increased risk of skin malignancy. Trichlemmal carcinoma is a rare malignant adnexal tumor mostly in sun-exposed areas. CASE PRESENTATION: We are presenting a case of a 35-year-old albino patient with a previous history of squamous cell carcinoma with full recovery. Presented with bilateral axillary masses with no other finding in history or examination. Short period deference between the two tumors with rapidly growing course. Both tumors were excised but in different operations, one covered with latissimus dorsi and the other primarily. Both tumor histopathologies revealed trichilemmal carcinoma with a free tumor margin. DISCUSSION: Albinism, caused by tyrosine deficiency and characterized by a lack of melanin, significantly increases susceptibility to ultraviolet (UV) radiation and skin cancers, particularly squamous cell carcinoma (SCC) and basal cell carcinoma (BCC). Trichlmmal carcinoma TLC, an uncommon malignancy from hair follicle structures, is notably rare, comprising <
0.005 % of adnexal carcinomas. Post-surgical analysis confirmed TLC with clear margins, emphasizing the need for vigilant follow-up to monitor for recurrence or new lesions. Strong sun protection measures-such as protective clothing and broad-spectrum sunscreen-are essential for individuals with albinism. CONCLUSION: This case illustrates the necessity for healthcare providers to be aware of the diverse skin cancer risks in patients with albinism and to implement tailored preventive strategies.