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Feoli F, Stieber D, Bormans A, Corsten M. Atypical Melanocytic Matricoma: A Case Report with Molecular Studies. Am J Dermatopathol 2023; 45:712-717. [PMID: 37462164 DOI: 10.1097/dad.0000000000002494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/22/2023]
Abstract
ABSTRACT Melanocytic matricoma is a rare benign pilar tumor characterized by matrical differentiation and interspersed dendritic melanocytes. It may show cellular atypia and brisk mitotic activity. Histological characterization of some lesions may be difficult. In addition, because the reported cases are few and have limited follow-up, there is insufficient experience to define outcome-based criteria for malignancy. Some cases of melanocytic matricoma with more prominent atypia have been reported as malignant, but their clinical behavior is uncertain. We present a melanocytic matricoma with interspersed benign dendritic melanocytes, but moderate basaloid atypia, focally brisk mitotic activity, and atypical mitoses. Despite the apparently good delimitation of this tumor, higher magnification revealed a slightly irregular border. However, overt malignant features such as necrosis, frank asymmetry, deep infiltration, and ulceration were not present. This tumor showed a complex aberrant genomic profile with multiple whole chromosomes or chromosomal arms, losses, and duplications. The tumor mutational burden was high. A loss-of-function alteration in CDKN2A and a loss-of-function mutation in TP53 were also present. This unexpected molecular profile contrasts with the relatively bland histology of the tumor and is in line with the difficulties in microscopic differential diagnosis between melanocytic matricoma and an indolent malignant pilomatrical tumor. We suggest that molecular studies and longer follow-up periods may help to further understand and more precisely categorize borderline pilomatrical tumors with melanocytic hyperplasia.
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Affiliation(s)
- Francesco Feoli
- Unité d'Histopathologie et de Mycologie Cutanée, CHU Saint Pierre, ULB, Brussels, Belgium
| | - Daniel Stieber
- Laboratoire National de Santé, National Center of Genetics, Molecular Genetic Unit, Dudelange, Luxemburg
| | - Anne Bormans
- Institutional Library, Institut Jules Bordet, ULB, Brussels, Belgium; and
| | - Marcus Corsten
- Chirurgie Plastique SaarLorLux, Mondorf-les-Bains, Luxemburg
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Nogales-Moro A, Pinilla-Pagnon I, Silvestre-Torner N, Romero-Jiménez B, García de Casasola-Rodríguez G, Chao-Crecente M. Melanocytic Matricoma With Atypical Histopathological Features: A Case Report of an Extremely Rare Entity and Review of the Literature. Am J Dermatopathol 2023; 45:400-408. [PMID: 37073985 DOI: 10.1097/dad.0000000000002427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/20/2023]
Abstract
ABSTRACT Melanocytic matricoma with atypical features is a rare, biphasic adnexal neoplasm displaying hair matrix differentiation, with only 3 reported cases worldwide. Generally, the lesion comprised a solid matrical and supramatrical cell proliferation, admixed with intermediate cell aggregates with sparse anucleated "shadow cells" and a prominent pigmented melanocytic hyperplasia. We report the case of a 78-year-old man with a slow-growing crusted lesion on the frontal left scalp, which in a matter of 1-2 months became a 0.6 cm well-defined, black purplish exophytic nodule. Histopathologically, the lesion presented a well-circumscribed border with a nodular dermal growth pattern, presenting different architectural features varying from benign pilomatricoma-like changes to atypical features such as moderate-to-high nuclear pleomorphism in both basaloid (matrical/supramatrical) and epidermal (keratinous) components. Strong nuclear and cytoplasmic positivity for β-catenin was observed in matrical cells, whereas prominent cytoplasmic membrane positivity for Melan-A in dendritic melanocytes. Owing to the evidence of atypical cytological features, we propose the "atypical/borderline" category of melanocytic matricoma as part of a possible spectrum among matrical neoplasms. Pathologists should be aware of any atypical histopathological features while reporting cases due to their potential malignant transformation.
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Affiliation(s)
- Adrián Nogales-Moro
- Department of Pathology, Hospital Universitario Severo Ochoa, Leganés (Madrid), Spain; and
| | - Ignacio Pinilla-Pagnon
- Department of Pathology, Hospital Universitario Severo Ochoa, Leganés (Madrid), Spain; and
| | | | - Belén Romero-Jiménez
- Department of Dermatology, Hospital Universitario Severo Ochoa, Leganés (Madrid), Spain
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Belzer A, Becerra C, Clune J, Malik M, Leventhal JS, Cowper SE, Johnson RL. Histopathologic features and immunohistochemistry findings to assist the dermatopathologist in differentiating melanocytic matrical carcinoma from melanoma. J Cutan Pathol 2023; 50:471-474. [PMID: 36645720 DOI: 10.1111/cup.14376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 11/13/2022] [Accepted: 12/01/2022] [Indexed: 01/17/2023]
Affiliation(s)
- Annika Belzer
- Yale School of Medicine, New Haven, Connecticut, USA
| | - Carla Becerra
- Department of Surgery, Yale School of Medicine, New Haven, Connecticut, USA
| | - James Clune
- Department of Surgery, Yale School of Medicine, New Haven, Connecticut, USA
| | - Mohsin Malik
- Dermatology Physicians of Connecticut, Shelton, Connecticut, USA
| | | | - Shawn E Cowper
- Department of Dermatology, Yale School of Medicine, New Haven, Connecticut, USA.,Department of Pathology, Yale School of Medicine, New Haven, Connecticut, USA
| | - Rebecca L Johnson
- Department of Dermatology, Yale School of Medicine, New Haven, Connecticut, USA.,Department of Pathology, Yale School of Medicine, New Haven, Connecticut, USA
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Muacevic A, Adler JR, Soughi M, Elabbad H, Baybay H, Mernissi FZ, Elfatemi H, Chbani L, Hammas N. Malignant Melanocytic Matricoma: A Rare Skin Tumor That Can Clinically Mimic Melanoma. Cureus 2023; 15:e34105. [PMID: 36843770 PMCID: PMC9946693 DOI: 10.7759/cureus.34105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/23/2023] [Indexed: 01/24/2023] Open
Abstract
Malignant melanocytic matricoma (MMM) is an extremely rare skin malignant neoplasm composed of epithelial cells with matrical differentiation and dendritic melanocytes. We found only 11 cases reported in the literature to date according to the databases consulted (PubMed/Medline, Scopus, and Web of Science). Here, we report a case of MMM in an 86-year-old woman. A histological examination showed a dermal tumor with a deep infiltrative pattern, without an epidermal connection. On immunohistochemical staining, tumor cells were positive for cytokeratin AE1/AE3, p63, and beta-catenin (nuclear and cytoplasmic staining) and negative for HMB45, Melan-A, S-100 protein, and androgen receptor. Melanic antibodies highlighted scattered dendritic melanocytes in tumor sheets. The findings did not support the diagnosis of melanoma, poorly differentiated sebaceous carcinoma, and basal cell carcinoma, but supported the diagnosis of MMM.
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Melson GJ, Hong SG, Brem CE. Melanocytic matricoma with atypical features: A case of malignant melanocytic matricoma? J Dermatol 2022; 49:1193-1197. [PMID: 35906811 DOI: 10.1111/1346-8138.16536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 06/22/2022] [Accepted: 07/19/2022] [Indexed: 11/27/2022]
Abstract
Melanocytic matricoma is a rarely reported, benign cutaneous adnexal neoplasm composed of epithelial cells exhibiting differentiation towards hair matrix as well as admixed, pigmented, dendritic melanocytes. The proposed malignant counterpart to melanocytic matricoma, malignant melanocytic matricoma (MMM), is even more rare. Here we report a case of a melanocytic matricoma with atypical features in a 92-year-old female with a 1.2-cm pigmented nodule on the right nasal sidewall. Histopathology revealed a well-circumscribed dermal tumor composed of atypical matrical cells with scattered aggregates of anucleate keratinocytes (ghost cells), prominent intratumoral pigment, numerous mitotic figures (88 mitosis/10 high-power field [HPF]), and intermixed dendritic melanocytes. A literature review was performed for MMM to determine if the current case fit diagnostic criteria for this entity. Including the current case, 12 cases of MMM were identified and analyzed to investigate common clinical and histopathologic features. MMM commonly occurred on the head and neck (7/12 cases) of older individuals (median age of 80) with a slight male predominance (male-to-female ratio of 3:1) and on histopathology presented as a multinodular dermal tumor composed of mitotically active (average mitotic rate of >50 mitoses/10 HPF) pleomorphic epithelial cells with foci of ghost cells. Dendritic melanocytes were found throughout the tumor lobules in all cases. Given that only two of 12 cases have exhibited locally aggressive behavior, further study is warranted to determine the true malignant potential of MMM.
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Affiliation(s)
- Gabriella J Melson
- Section of Dermatopathology, Department of Dermatology, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Sophiette G Hong
- Section of Dermatopathology, Department of Dermatology, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Candice E Brem
- Section of Dermatopathology, Department of Dermatology, Boston University School of Medicine, Boston, Massachusetts, USA
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