Cases reported "Pilomatrixoma"

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11/20. Inverted malignant pilomatricoma of the neck.

    Malignant pilomatricoma is an uncommon malignant follicular adnexal tumor with a predilection for the head and neck among older males. We report the case of a male with an inverted malignant pilomatricoma of the left neck. The initial diagnostics and the treatment pointed to carcinoma of unknown primary (CUP syndrome). The preoperative diagnostic tests included ultrasound examination, CT scan and fine-needle aspiration cytology. However, the preoperative diagnostics did not provide any further information, leading to doubts concerning the initially proposed diagnosis. histology of the resected tumor revealed a malignant pilomatricoma. We report the clinical presentation and the management of this case and discuss the clinical and histological findings.
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12/20. Pilomatrix carcinoma of the back treated by mohs micrographic surgery.

    BACKGROUND: Pilomatrix carcinoma (synonyms, matrical carcinoma or malignant pilomatrixoma) is a rare malignant neoplasm derived from the hair matrix first described in 1980. This neoplasm can exhibit local aggressive behavior and distant metastasis. Most pilomatrix carcinomas occur on the head and neck of elderly individuals with a predilection for males (M:F 5:1). Pilomatrix carcinoma is often clinically misdiagnosed as a sebaceous cyst and histologic difficulty can occur in differentiating this entity from the benign entity pilomatrixoma. OBJECTIVE: The objective was to describe a case of pilomatrix carcinoma encountered in a Mohs micrographic surgery practice. We present the first case of this lesion treated by mohs surgery. methods: A case report and literature review are presented. CONCLUSION: Pilomatrix carcinoma is a rare malignant variant of pilomatrixoma. Given the rarity of this lesion there are no well-defined standards for surgical management. Wide local excision has been recommended given the high rate of reoccurrence. Mohs micrographic surgery may provide optimal treatment of this neoplasm given the ability to have 100% margin control.
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13/20. pilomatrixoma of the head and neck.

    pilomatrixoma is a benign skin appendage tumor that commonly occurs as a solitary lesion and is not usually hereditary. There is evidence to suggest that patients with a family history of multiple pilomatrixomas have a high probability of autosomal dominant disorders such as myotonic dystrophy, gardner syndrome, and rubinstein-taybi syndrome. In January 2004, a case was reported of an 8-year-old girl with 2 progressively enlarged facial masses. One of them was excised and diagnosed as pilomatrixoma. Coincidently, her 13-year-old sister had the same type of tumor when she was 4 years old. We report this unusual case and review the literature. pilomatrixoma has not been widely reported in the head and neck surgery literature. This benign tumor may be misdiagnosed as a carcinoma, resulting in unnecessary aggressive therapy. Otolaryngologists should therefore note the clinical and pathologic characteristics of these symptoms.
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14/20. Giant pilomatrixoma arising in the preauricular region: a case report.

    pilomatrixoma is a rare, benign, calcifying cutaneous tumor, originating from pluripotential precursors of hair matrix cells. It is most commonly seen in the head and neck region, occurring in the first two decades of life. It usually occurs as a single nodule with a diameter of 0.5-3 cm, localized dermally or subcutaneously. Clinical diagnosis may be difficult when it presents in a large, ulcerated form or in elderly patients. A 65-year-old female presented with a painful and progressive, cutaneous, firm-solid mass with a diameter of 6 x 4 cm in the left preauricular region. The mass was surgically excised under general anesthesia. Histopathological diagnosis of the mass was pilomatrixoma which showed basophilic cells, shadow cells, and calcifications. Postoperative result of the operation field was cosmetically and functionally acceptable.
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15/20. Aggressive pilomatrixoma of the infra-auricular area: a case report.

    Although pilomatrixomas are well known among dermatologists and dermatopathologists, head and neck surgeons confronted with these lesions in the infra-auricular region do not consider this benign neoplasm in the differential diagnosis. Aggressive pilomatrixoma is a benign tumor of the hair matrix cells affecting mainly children. Histologically, the border between aggressive pilomatrixoma and pilomatrix carcinoma is still not clear. We report the case of a 15-year-old Turkish boy suffering from an aggressive pilomatrixoma of the infra-auricular region and review the literature about this unclear entity.
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16/20. A case of perforating pilomatricoma.

    Pilomatricoma is a rare skin neoplasm, most commonly seen in the head and neck region, and occurring in the first two decades of life. It is usually solitary and varies from 0.5 to 2 cm in diameter. Its etiology is unknown. Perforating pilomatricoma is a rare clinical variant that presents as a draining, crusted nodule or ulcer, and is reported to arise faster than the classic pilomatricoma. Herein, we report a case of 35-year-old female, who had a 4-month history of a growing mass on her leg. On physical examination, a 4-cm diameter, asymptomatic, erythematous, ulcerated mass was noted on the left anterio-lateral upper leg. The first histopathological analysis of a punch biopsy from the lesion was reported as basal cell carcinoma. Therefore, the lesion was totally excised. There were shadow cells, squamoid cells, and basaloid aggregations more prominently in the one area in the tumor. In addition, calcification, foreign body giant cells and inflammatory cells were present. Punch or excisional biopsies are preferred as a method of diagnosis for the majority of cutaneous neoplasms. If total excision is not the method of choice, multiple punch biopsies should be made from different areas in large skin tumors for correct diagnosis.
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17/20. pilomatrixoma of the earlobe.

    BACKGROUND. pilomatrixoma most commonly occurs in the head and neck region, appearing primarily in the first two decades of life. The lesion is described as a tumor with differentiation toward hair cells and surgical excision is the treatment of choice. OBJECTIVE. We report an uncommon localization of a perforating type pilomatrixoma of 5 x 4 x 4 cm in size that developed from the earlobe. methods. Histopathological examination revealed pilomatrixoma. Total resection of the tumor was performed. The earlobe was reconstructed by forming a posterior-superior pedicled skin flap. RESULTS. No recurrence was observed and a good cosmetic result was obtained. CONCLUSION. Local recurrence does not generally occur if the tumor is completely removed. The case we present is of interest in having a history of trauma to the region and a relatively rapid growth with perforation of the overlying skin.
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keywords = neck
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18/20. Pilomatrix carcinoma with multiple visceral metastases. Report of a case.

    BACKGROUND. The malignant variant of pilomatrixoma is pilomatrix carcinoma, a low-grade, malignant lesion with a tendency to recur. Only three cases with visceral metastases, occurring some years after primary diagnosis, have been reported. methods. A case of metastatic pilomatrix carcinoma of the neck in a patient, age 50 years, is presented. RESULTS. Histologic examination of the cutaneous lesion showed a dense infiltrate of basaloid cells, an abrupt transition to shadow cells, and central necrosis. Two months after primary diagnosis, pulmonary and brain metastases developed. Despite chemotherapy and irradiation, the patient died a widespread disease 18 months after the primary diagnosis. An autopsy confirmed the diagnosis of pilomatrix carcinoma with metastases to several organs including the heart, lung, brain, liver, pancreas, kidney, adrenal gland, gastric and colorectal submucosa, skin, and bone. CONCLUSIONS. Pilomatrix carcinoma is very rare and usually behaves like a low-grade, malignant lesion with a tendency to recur. This patient's tumor is unique because of its highly aggressive behavior and visceral metastases.
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keywords = neck
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19/20. Fine needle aspiration diagnosis of pilomatrixoma. A case report.

    BACKGROUND: Fine needle aspiration (FNA) diagnosis of pilomatrixoma is rare. The cytologic presentation can be mistaken for squamous cell carcinoma because of high cellularity, high nuclear/cytoplasmic ratio and presence of anucleate squames. CASE: A 25-year-old male presented to Cook County Hospital with a slowly enlarging neck mass of three months' duration. FNA was interpreted as consisted with pilomatrixoma. Subsequently the patient had the mass removed. histology confirmed the diagnosis of pilomatrixoma. CONCLUSION: The wide range of cell differentiation in conjunction with pertinent clinical findings, absence of nuclear atypia, tumor diathesis, mitotic figures and awareness of the entity lead to the correct diagnosis of pilomatrixoma.
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20/20. CT of pilomatrixoma in the cheek.

    pilomatrixoma is an uncommon benign tumor arising from hair follicles. They occur most commonly in the head and neck region, and are usually found in girls during the first two decades of life. These tumors may contain calcification, which, when present, is helpful in suggesting the diagnosis. We present a classic case of pilomatrixoma in the cheek of a young woman. The tumor was documented on CT studies, which showed a subcutaneous, noninvasive mass with calcifications.
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keywords = neck
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