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Proliferating Giant Pilomatrixoma: A Case Report
Liliana Berenice Alcázar García1, Zabdy Elienai Frayre García1, Alejandra Zahaydé Grijalva Aguilar2
1Dermatology, Instituto Dermatológico de Jalisco "Dr. José Barba Rubio", Guadalajara, MEX.
Insights
Giant pilomatrixoma, a rare variant of a benign hair follicle tumor, can mimic malignancy. This case highlights a rapidly growing giant pilomatrixoma, emphasizing the need for complete surgical excision to prevent recurrence.
Area of Science:
- Dermatology
- Pathology
- Oncology
Background:
- Pilomatrixoma is a benign skin tumor originating from the hair follicle matrix.
- It commonly affects pediatric and young adult populations.
- Clinicopathological variants exist, including giant pilomatrixoma (≥4 cm).
Observation:
- A 36-year-old female presented with a rapidly growing exophytic mass on her right cheek after trauma.
- The mass raised suspicion for malignancy due to its size and rapid growth.
- Histopathological examination revealed a proliferating pilomatrixoma.
Findings:
- The case presented a giant pilomatrixoma, defined by its size (≥4 cm).
- The histological subtype was identified as proliferating pilomatrixoma.
- The tumor mimicked malignant neoplasms like angiosarcoma or amelanotic melanoma.
Implications:
- Giant and proliferating pilomatrixoma variants require careful diagnosis to differentiate from malignant tumors.
- Complete surgical excision is crucial for managing giant pilomatrixoma.
- Incomplete excision can lead to local recurrence and potential malignant transformation.
Abstract:
Pilomatrixoma is a benign adnexal tumor, frequently observed in pediatric and young adult populations, and originates from the hair follicle matrix. While the most common clinical presentation is a subcutaneous nodule, multiple clinicopathological variants have been identified. One such variant is the giant pilomatrixoma, defined by a size of 4 cm or greater, which may mimic malignant neoplasms such as angiosarcoma or amelanotic melanoma in adults. We present the case of a 36-year-old female patient who presented with an exophytic mass on the right cheek, which exhibited rapid growth following trauma. Due to the suspicion of malignancy, an excisional biopsy with a 5 mm margin was performed, and histopathological examination revealed a proliferating pilomatrixoma. This case is noteworthy for presenting two variants: classification by size (giant pilomatrixoma) and histological subtype (proliferative). It is essential to ensure appropriate surgical management, as incomplete excision may lead to local recurrence and/or malignant transformation.
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