Related Experiment Video
Updated: Jul 11, 2026
Clinical Imaging of Microwave Mammography
Published on: November 14, 2025
[Breast pilomatrixoma manifested as microcalcifications on mammography: report of two cases]
Abstract:
Pilomatricoma is a benign tumor of hair follicule origin corresponding to a firm subcutaneous nodule requiring histology for diagnosis. Only few breast pilomatricomas have been reported, with imaging showing well defined nodules with microcalcifications. We report two cases of intra-mammary pilomatricomas presenting as ACR BI-RADS 4 and 5 microcalcifications, suspicious for malignant tumors. Percutaneous biopsy confirmed the histological diagnosis. Malignant pilomatricomas have been reported, suggesting that all pilomatricomas should be resected.
Insights
Pilomatricomas are rare benign hair follicle tumors. These two breast cases mimicked cancer on imaging, highlighting the need for biopsy and potential resection.
Area of Science:
- Oncology
- Dermatopathology
- Radiology
Background:
- Pilomatricoma is a benign appendageal tumor originating from the hair follicle.
- Breast pilomatricomas are exceptionally rare, often presenting as asymptomatic subcutaneous nodules.
- Histological examination is the gold standard for pilomatricoma diagnosis.
Observation:
- Two cases of intra-mammary pilomatricomas are presented.
- Imaging revealed microcalcifications, leading to ACR BI-RADS classification of 4 and 5.
- These findings raised suspicion for malignancy on initial radiological assessment.
Findings:
- Percutaneous biopsy was crucial in confirming the benign pilomatricoma diagnosis in both cases.
- The imaging features, particularly microcalcifications, mimicked malignant breast lesions.
- While typically benign, malignant pilomatricomas have been documented in literature.
Implications:
- This case series underscores the importance of considering pilomatricoma in the differential diagnosis of suspicious breast microcalcifications.
- Accurate diagnosis relies on histological confirmation, often necessitating biopsy.
- Complete surgical resection is recommended for all pilomatricomas due to the rare possibility of malignant transformation.
