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Pilomatrical Carcinoma, Pathology, follicular matrix,
Pilomatrical carcinoma is a rare, locally aggressive malignancy of follicular matrix origin. It presents as a rapidly growing, flesh-colored, or blueish, exophytic nodule with tumor asymmetry and poor circumscription. Histological features of these tumors include dominant hyperchromatic basaloid cells with high mitotic rate and nuclear pleomorphism; along with anucleate matrical cells and central necrosis. Pilomatrical carcinomas demonstrate a high rate of recurrence and tendency to metastasize. The most described treatment is wide excision of the tumor with negative margins with or without adjuvant radiation therapy. We present the case of a 70-year-old female patient who presented to the office with a 3-year history of a growing, exophytic lesion on the right nasal ala. A biopsy of the lesion was obtained, and histologic examination was consistent with a diagnosis of pilomatrical carcinoma.
Herrmann JL, Allan A, Trapp KM, et al. Pilomatrix carcinoma: 13 new cases and review of the literature with emphasis on predictors of metastasis. J Am Acad Dermatol. 2014 Jul; 71(1):38-43.e2
Lazar AJF, Calonje E, Grayson W, et al. Pilomatrix carcinomas contain mutations in CTNNB1, the gene encoding β-catenin. Journal of Cutaneous Pathology. 2005 Feb;32(2):148-57
Hardisson D, Linaves MD, et al. Pilomatrix carcinoma: a clinicopathologic study of six cases and review of the literature. Am J Dermatopahol. 2001 Oct;23(5):394-401
Aherne NJ, Fitzpatrick DA, et al. Pilomatrix carcinoma presenting as an extra axial mass: clinicopathological features. 2008 Nov 29;3:47
Melancon JM, Tom WL, et al. Management of pilomatrix carcinoma: a case report of successful treatment with Mohs micrographic surgery and review of the literature. Dermatol Surg. 2011 Dec;37(12): 1798-805
Aloi F G, Molinero A, and Pippione M. Basal Cell Carcinoma with Matrical Differentiation. Matrical Carcinoma. American journal of dermatopathology. 1988 Dec;10(6): 509–513.
Xing L, Marzolf SA, et al. Facial pilomatrix carcinomas treated with Mohs micrographic surgery. JAAD Case Rep. 2018 Mar 3;4(3): 253-255