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A Case of Exophytic Pilomatricoma Clinically Resembling Keratoacanthoma

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Dear Editor: Pilomatricoma is a benign cutaneous tumor which presents as solitary, slow-growing, firm nodule with normal overlying skin... Exophytic pilomatricoma, an uncommon subtype, shows distinctive features such as rapid development, reddish exophytic appearance, surface alteration suggestive of perforation, and relatively shallow location... At initial visit the mass measured approximately 10 millimeters in diameter... The patient did not recall any history of trauma prior to lesion appearance... Under the impression of keratoacanthoma partial wedge biopsy was performed... Considering the visual appearance and the histologic features we diagnosed the mass as exophytic subtype of pilomatricoma... Pilomatricoma is a common tumor especially among children but its accurate preoperative diagnosis is challenging due to clinical resemblance to various other tumors... This finding suggests that clinical resemblance to keratoacanthoma is much more unusual... So far, it has been reported in only 2 cases... In some cases of exophytic pilomatricoma when elimination of the tumor content occur they are more often referred to as perforating pilomatricoma... These findings can also be found in cases of perforating pilomatricomas... Due to rapid growth of the tumor clinicians have a shorter time to diagnosis... With surgical excision the recurrence rate is low... In one study average time to recurrence was 1.6 years, indicating the need for long term follow-up monitoring after the treatment.

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Multiple masses within dermis. Eosinophilic ghost cells can be seen in the center and basaloid cells in the peripheral portion (H&E, ×40).
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Figure 2: Multiple masses within dermis. Eosinophilic ghost cells can be seen in the center and basaloid cells in the peripheral portion (H&E, ×40).

Mentions: Upon histologic examination, instead of keratin-filled crater and epithelial proliferation the mass was surrounded by basaloid cells with eosinophilic ghost cells in the central portion. These findings led us to suspect pilomatricoma rather than keratoacanthoma. For further evaluation complete surgical excision was conducted. The resected tumor revealed multiple masses in dermis layer with histologic findings equivalent to the previous specimen (Fig. 2). Considering the visual appearance and the histologic features we diagnosed the mass as exophytic subtype of pilomatricoma.


A Case of Exophytic Pilomatricoma Clinically Resembling Keratoacanthoma
Multiple masses within dermis. Eosinophilic ghost cells can be seen in the center and basaloid cells in the peripheral portion (H&E, ×40).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5383765&req=5

Figure 2: Multiple masses within dermis. Eosinophilic ghost cells can be seen in the center and basaloid cells in the peripheral portion (H&E, ×40).
Mentions: Upon histologic examination, instead of keratin-filled crater and epithelial proliferation the mass was surrounded by basaloid cells with eosinophilic ghost cells in the central portion. These findings led us to suspect pilomatricoma rather than keratoacanthoma. For further evaluation complete surgical excision was conducted. The resected tumor revealed multiple masses in dermis layer with histologic findings equivalent to the previous specimen (Fig. 2). Considering the visual appearance and the histologic features we diagnosed the mass as exophytic subtype of pilomatricoma.

View Article: PubMed Central - PubMed

AUTOMATICALLY GENERATED EXCERPT
Please rate it.

Dear Editor: Pilomatricoma is a benign cutaneous tumor which presents as solitary, slow-growing, firm nodule with normal overlying skin... Exophytic pilomatricoma, an uncommon subtype, shows distinctive features such as rapid development, reddish exophytic appearance, surface alteration suggestive of perforation, and relatively shallow location... At initial visit the mass measured approximately 10 millimeters in diameter... The patient did not recall any history of trauma prior to lesion appearance... Under the impression of keratoacanthoma partial wedge biopsy was performed... Considering the visual appearance and the histologic features we diagnosed the mass as exophytic subtype of pilomatricoma... Pilomatricoma is a common tumor especially among children but its accurate preoperative diagnosis is challenging due to clinical resemblance to various other tumors... This finding suggests that clinical resemblance to keratoacanthoma is much more unusual... So far, it has been reported in only 2 cases... In some cases of exophytic pilomatricoma when elimination of the tumor content occur they are more often referred to as perforating pilomatricoma... These findings can also be found in cases of perforating pilomatricomas... Due to rapid growth of the tumor clinicians have a shorter time to diagnosis... With surgical excision the recurrence rate is low... In one study average time to recurrence was 1.6 years, indicating the need for long term follow-up monitoring after the treatment.

No MeSH data available.


Related in: MedlinePlus