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Mlay K, Shija P, Magwizi M, Karuga EG, Mtenga P, Mremi A. Giant pilomatrix carcinoma of the scalp with intracranial extension: A case report. Clin Case Rep 2023; 11:e8123. [PMID: 37927987 PMCID: PMC10625130 DOI: 10.1002/ccr3.8123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2023] [Revised: 10/03/2023] [Accepted: 10/16/2023] [Indexed: 11/07/2023] Open
Abstract
Key Clinical Message A very rare skin cancer. Malignant variant of pilomatricoma. It is unique because of its highly aggressive behavior. Responds poorly to chemotherapy and radiotherapy. Treated with a wide surgical excision with safe margins. Abstract Pilomatrix carcinoma is uncommon and locally aggressive tumor of the hair follicle matrix. It is a malignant variant of pilomatricoma. If left untreated for a long time may attain massive size and has the potential for distant spread. Only few cases with brain extension have been reported in the literature. Diagnosis of these tumors is established by histopathology. Although pilomatrixoma and pilomatrix carcinoma are well-recognized lesions, clinically they are frequently misdiagnosed as other skin conditions. The tumors respond poorly to chemotherapy and radiotherapy. Thus, recommended treatment is a wide surgical excision with safe margins. Herein, we report the case of a 39-year-old African woman with pilomatrix carcinoma of the scalp eroding the skull bone with intracranial extension.
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Affiliation(s)
- Kenneth Mlay
- Department of OtorhinolaryngologyKilimanjaro Christian Medical CentreMoshiTanzania
- Faculty of MedicineKilimanjaro Christian Medical University CollegeMoshiTanzania
| | - Peter Shija
- Department of OtorhinolaryngologyKilimanjaro Christian Medical CentreMoshiTanzania
- Faculty of MedicineKilimanjaro Christian Medical University CollegeMoshiTanzania
| | - Marco Magwizi
- Department of OtorhinolaryngologyKilimanjaro Christian Medical CentreMoshiTanzania
- Faculty of MedicineKilimanjaro Christian Medical University CollegeMoshiTanzania
| | - Ezekiel G. Karuga
- Department of OtorhinolaryngologyKilimanjaro Christian Medical CentreMoshiTanzania
| | - Philbert Mtenga
- Department of OtorhinolaryngologyKilimanjaro Christian Medical CentreMoshiTanzania
- Faculty of MedicineKilimanjaro Christian Medical University CollegeMoshiTanzania
| | - Alex Mremi
- Faculty of MedicineKilimanjaro Christian Medical University CollegeMoshiTanzania
- Department of PathologyKilimanjaro Christian Medical CentreMoshiTanzania
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Toffoli L, Bazzacco G, Conforti C, Guarneri C, Giuffrida R, Zelin E, di Meo N, Zalaudek I. Pilomatrix Carcinoma: Report of Two Cases of the Head and Review of the Literature. Curr Oncol 2023; 30:1426-1438. [PMID: 36826070 PMCID: PMC9955132 DOI: 10.3390/curroncol30020109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 01/09/2023] [Accepted: 01/14/2023] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Pilomatrix carcinoma (PC) is a rare skin tumor arising from hair follicle matrix cells. It is locally aggressive with a high rate of local recurrence after surgical excision. Few cases in the literature have been described and the management is not well defined. OBJECTIVES The aim of this study was to present two cases of PC located on the head and review the relevant literature about epidemiology, clinical and dermoscopic evaluation, characteristics of local and distant metastases, local recurrence rate and management of this rare skin tumor. METHODS We consulted databases from PubMed, Research Gate and Google Scholar, from January 2012 to November 2022. We reviewed the literature and reported two additional cases. RESULTS We selected 52 tumors in middle-aged to older patients located mostly on the head. Dermoscopy evaluation was rarely performed in the pre-operative diagnostic setting. The most definitive treatment was wide local excision, but local recurrences were common. In total, we observed 11 cases of recurrences and 9 patients with locoregional or distant metastases. Four patients received adjuvant radiotherapy, two patients needed chemotherapy and local cancer therapy and one patient received radiochemotherapy. CONCLUSION Our reports and the review of the literature can provide a better awareness and management of this rare tumor.
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Affiliation(s)
- Ludovica Toffoli
- Dermatology Clinic of Trieste, Maggiore Hospital, University of Trieste, 34100 Trieste, Italy
| | - Giulia Bazzacco
- Dermatology Clinic of Trieste, Maggiore Hospital, University of Trieste, 34100 Trieste, Italy
- Correspondence: (G.B.); (R.G.)
| | - Claudio Conforti
- Dermatology Clinic of Trieste, Maggiore Hospital, University of Trieste, 34100 Trieste, Italy
| | - Claudio Guarneri
- Department of Biomedical and Dental Sciences and Morpho Functional Imaging, University of Messina, 98124 Messina, Italy
| | - Roberta Giuffrida
- Department of Clinical and Experimental Medicine, Dermatology, University of Messina, 98124 Messina, Italy
- Correspondence: (G.B.); (R.G.)
| | - Enrico Zelin
- Dermatology Clinic of Trieste, Maggiore Hospital, University of Trieste, 34100 Trieste, Italy
| | - Nicola di Meo
- Dermatology Clinic of Trieste, Maggiore Hospital, University of Trieste, 34100 Trieste, Italy
| | - Iris Zalaudek
- Dermatology Clinic of Trieste, Maggiore Hospital, University of Trieste, 34100 Trieste, Italy
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Pilomatrical Carcinoma of the Scalp in a Setting of Pilomatricoma and Trichilemmal Cysts—a Rare Entity. Indian J Surg 2021. [DOI: 10.1007/s12262-020-02166-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Eckhoff MD, Tadlock J, Kafchinski LA. Pilomatrix Carcinoma of the Antecubitum. Cureus 2020; 12:e6821. [PMID: 32190433 PMCID: PMC7054892 DOI: 10.7759/cureus.6821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
We present the case of a 46-year-old male with atypically large left elbow pilomatrix carcinoma present for 10 years with emergent excision after developing life-threatening hemorrhage. Pilomatrix carcinoma is a dermal-based malignant tumor typically of the head and neck region. Histopathology shows islands of basaloid cells, shadow cells, and fibromyxoid fibroma. Reoccurrence is seen in 23% of cases on an average of six months after primary excision. The current standard of care is wide excision with close follow-up.
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Affiliation(s)
- Michael D Eckhoff
- Orthopedics, Texas Tech University Health Sciences Center El Paso, Paul L. Foster School of Medicine, El Paso, USA
| | - Joshua Tadlock
- Orthopedics, Texas Tech University Health Sciences Center El Paso, Paul L. Foster School of Medicine, El Paso, USA
| | - Lisa A Kafchinski
- Orthopedics, Texas Tech University Health Sciences Center El Paso, El Paso, USA
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Le ST, Kamal HY, Khachemoune A. Mohs micrographic surgery for cutaneous malignancies: A focus review of its indications in pediatric age groups. Pediatr Dermatol 2018; 35:434-440. [PMID: 29575263 DOI: 10.1111/pde.13460] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Mohs micrographic surgery (MMS) is a highly specialized technique that has been successful in the treatment of a variety of skin tumors. The technique can be performed as an outpatient procedure and encompasses surgical excision and intraoperative assessment of tumor margins in one setting by the same physician. The process ensures precise margin control with maximal preservation of healthy tissues. Mohs micrographic surgery has been practiced worldwide, including in the United States, Europe (United Kingdom, Germany, Spain, Netherlands, Switzerland), and Australia. Although it is commonly performed in adults with greater success, it has been discussed less frequently in children. In this article, we describe several cutaneous tumors in children and the role of Mohs micrographic surgery in their management. A PubMed search was conducted to review the most common cutaneous tumors in children treated using Mohs micrographic surgery. In this review, we discuss indications for Mohs micrographic surgery and pertinent studies examining success rates in children. Mohs micrographic surgery has been used to treat several tumors in children and offers the advantage of high cure rates and tissue conservation. This report emphasizes the benefits of Mohs micrographic surgery in children and highlights several cutaneous tumors for which it has been used to treat successfully.
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Affiliation(s)
- Stephanie T Le
- Drexel/Hahnemann University Hospital, Philadelphia, PA, USA
| | | | - Amor Khachemoune
- State University of New York Downstate and Veterans Affairs Medical Center, Brooklyn, NY, USA
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Jones C, Twoon M, Ho W, Portelli M, Robertson BF, Anderson W. Pilomatrix carcinoma: 12-year experience and review of the literature. J Cutan Pathol 2017; 45:33-38. [DOI: 10.1111/cup.13046] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2016] [Revised: 09/03/2017] [Accepted: 09/11/2017] [Indexed: 11/29/2022]
Affiliation(s)
- Christopher Jones
- Plastic and Reconstructive Surgery Department; St John's Hospital; Livingston UK
| | - Mark Twoon
- Plastic and Reconstructive Surgery Department; St John's Hospital; Livingston UK
| | - Weiguang Ho
- Department of Plastic Surgery; Ulster Hospital; Belfast UK
| | - Mark Portelli
- Canniesburn Unit, Plastic and Reconstructive Surgery Department; Glasgow UK
| | | | - William Anderson
- Plastic and Reconstructive Surgery Department; St John's Hospital; Livingston UK
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ElBenaye J, Elkhachine Y, Sakkah A, Sinaa M, Moumine M, Jakar A, Elhaouri M. [Malignant proliferating trichilemmal cyst of the scalp: A case report]. ANN CHIR PLAST ESTH 2017; 63:97-101. [PMID: 28755831 DOI: 10.1016/j.anplas.2017.06.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Accepted: 06/18/2017] [Indexed: 11/18/2022]
Abstract
BACKGROUND Proliferating trichilemmal cyst (PTC) is a rare adnexal tumor, generally benign, primarily sitting on the scalp of elderly women. About fifty cases are reported in the literature. Herein, we describe another one particularly aggressive. OBSERVATION A 70-year-old woman had been showing an increase in the size of an occipital cyst for 6years. A cephalic scan and wide surgical excision had confirmed the diagnosis of a malignant PTC. Four months later, the tumor recurred with regional metastases and intracerebral invasion. DISCUSSION Through our case and based on the literature analyzing, we discuss the nosology of PTC and its clinical and histological distinctive elements. CONCLUSION Large studies are needed to better understand the specificities of PTC, specially malignant form, but it remains difficult because of its rarity.
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Affiliation(s)
- J ElBenaye
- Service de dermatologie, hôpital militaire Moulay-Ismaïl, 50000, Meknès, Maroc; Faculté de médecine et de pharmacie, 30000, Fès, Maroc.
| | - Y Elkhachine
- Service de dermatologie, hôpital militaire Moulay-Ismaïl, 50000, Meknès, Maroc; Faculté de médecine et de pharmacie, 30000, Fès, Maroc
| | - A Sakkah
- Service de dermatologie, hôpital militaire Moulay-Ismaïl, 50000, Meknès, Maroc; Faculté de médecine et de pharmacie, 30000, Fès, Maroc
| | - M Sinaa
- Service d'anatomo-pathologie, hôpital militaire Moulay-Ismaïl, 50000, Meknès, Maroc; Faculté de médecine et de pharmacie, 30000, Fès, Maroc
| | - M Moumine
- Service de chirurgie maxillo-faciale, hôpital militaire Moulay-Ismaïl, 50000, Meknès, Maroc; Faculté de médecine et de pharmacie, 30000, Fès, Maroc
| | - A Jakar
- Service de dermatologie, hôpital militaire Moulay-Ismaïl, 50000, Meknès, Maroc; Faculté de médecine et de pharmacie, 30000, Fès, Maroc
| | - M Elhaouri
- Service de dermatologie, hôpital militaire Moulay-Ismaïl, 50000, Meknès, Maroc; Faculté de médecine et de pharmacie, 30000, Fès, Maroc
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Romeu M, Foletti J, Chossegros C, Dales J, Berbis P, Cribier B, Guyot L. Les tumeurs cutanées malignes à différentiation pilaire de la face et du cuir chevelu : mise au point diagnostique et thérapeutique. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2017; 118:95-102. [DOI: 10.1016/j.jormas.2017.01.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2015] [Revised: 06/02/2016] [Accepted: 01/11/2017] [Indexed: 12/01/2022]
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Vadrucci M, Gilardi L, Crivelli F, Baroli A, Lomuscio G. 18F-FDG PET/CT in Metastatic Pilomatrix Carcinoma. Clin Nucl Med 2016; 41:e525-e526. [DOI: 10.1097/rlu.0000000000001405] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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