Pilomatrixoma breast mimicking carcinoma

Area of Science:

• Dermatology
• Oncology
• Surgical Pathology

Background:

• Pilomatrixoma is a benign appendageal tumor, typically occurring in the head and neck region of children and young adults.
• Breast pilomatrixoma is exceptionally rare, especially in adult males, leading to potential diagnostic confusion with malignant neoplasms.
• A painless, progressively increasing lump in the breast can present diagnostic challenges, necessitating accurate histopathological evaluation.

Purpose of the Study:

• To present a rare case of pilomatrixoma in a male breast.
• To discuss the diagnostic difficulties and implications of misdiagnosing pilomatrixoma as breast carcinoma.
• To emphasize the importance of histopathology in confirming the diagnosis of breast lumps.

Main Methods:

• Case report of a 50-year-old male patient presenting with a right breast lump.
• Review of clinical presentation, fine needle aspiration cytology (FNAC) findings, and surgical management.
• Histopathological examination of the modified radical mastectomy specimen.

Main Results:

• Fine needle aspiration cytology misdiagnosed the breast lump as carcinoma.
• Histopathological analysis of the resected specimen definitively diagnosed the lump as pilomatrixoma.
• The patient underwent modified radical mastectomy based on the initial misdiagnosis.

Conclusions:

• Pilomatrixoma should be considered in the differential diagnosis of breast lumps, even in adult males.
• Accurate preoperative diagnosis is crucial to avoid unnecessary aggressive surgical interventions.
• Histopathological examination remains the gold standard for definitive diagnosis of breast lesions.