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Journal of Indian Association of Pediatric Surgeons
     Journal of Indian Association of Pediatric Surgeons
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IMAGES
Year : 2021  |  Volume : 26  |  Issue : 6  |  Page : 462-463
 

Pilomatrixoma: A masquerader at uncommon sites


1 Department of Paediatric Surgery, All India Institute of Medical Sciences, New Delhi, India
2 Department of Pathology, All India Institute of Medical Sciences, New Delhi, India

Date of Submission07-Oct-2020
Date of Decision22-Nov-2020
Date of Acceptance16-Jul-2021
Date of Web Publication12-Nov-2021

Correspondence Address:
Dr. Prabudh Goel
Department of Paediatric Surgery, Room No. 4002, 4th Floor, Teaching Block, All India Institute of Medical Sciences, New Delhi - 110 029
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jiaps.JIAPS_269_20

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   Abstract 


The rarity, diverse clinical presentation, relatively featureless sonography, and diagnostic dilemma associated with pilomatrixomas may trigger anxiety and call for unwarranted investigations. The authors have shared their experience in two consecutive cases to generate awareness for such lesions.


Keywords: Basaloid cells, calcifying epithelioma of Malherbe, ghost cells, pilomatrixoma


How to cite this article:
Sharma K, Bajpai M, Yadav R, Goel P. Pilomatrixoma: A masquerader at uncommon sites. J Indian Assoc Pediatr Surg 2021;26:462-3

How to cite this URL:
Sharma K, Bajpai M, Yadav R, Goel P. Pilomatrixoma: A masquerader at uncommon sites. J Indian Assoc Pediatr Surg [serial online] 2021 [cited 2021 Dec 4];26:462-3. Available from: https://www.jiaps.com/text.asp?2021/26/6/462/330375




Case-1: A 12-year-girl with a painless, bony-hard swelling on medial aspect of left leg [Figure 1]. Radiography: No calcification; Sonography: No vascularity. Serology: Echinococcus-negative. Case-2: A 6-year-boy with a similar 4.2 cm × 3.8 cm mass in left flank. Histopathology was consistent with pilomatrixoma in either case [Figure 2]. Postexcision, patients are asymptomatic upon follow-up (4.5 and 2 years, respectively).
Figure 1: Pilomatrixoma. Clinical picture of the solitary lesion on medial aspect of left leg; with excised specimen (inset)

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Figure 2: The triad of ghost cells, basaloid cells with high nuclear: cytoplasmic ratio and chromatin/foreign body giant cells inside the nuclei are suggestive of Pilomatrixoma. Case 1 (a) The tumor shows nests of basaloid cells (black arrow) with abrupt trichilemmal type of keratinization and presence of ghost cells (blue arrow) ×200, H and E (left). Foci of calcification (black arrow) seen ×100, H and E (middle). Foreign body giant cell reaction (blue arrow) ×100, H and E (right). Case 2 (b) The tumor is composed of islands of basaloid cells which show abrupt trichilemmal type of keratinization and ghost cells in the center of the islands, ×100 (left and middle), ×200 (right) H and E

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Pilomatrixoma or “calcifying epithelioma of Malherbe” is a rare, benign, hair-follicle tumor[1] with a bimodal-peak presentation (first-and-sixth decades-of-life) and female-preponderance. The head-neck regions (>50% of cases) followed by upper extremities are commonly affected. Excision biopsy with clear margins is curative with recurrence reported in 0%–3%.[2]

Financial support and sponsorship

Nil.

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form, the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

Conflicts of interest

There are no conflicts of interest.



 
   References Top

1.
Moehlenbeck FW. Pilomatrixoma (calcifying epithelioma). A statistical study. Arch Dermatol 1973;108:532-4.  Back to cited text no. 1
    
2.
Kose D, Ciftci I, Harmankaya I, Ugras S, Caliskan U, Koksal Y. Pilomatrixoma in childhood. J Cancer Res Ther 2014;10:549-51.  Back to cited text no. 2
    


    Figures

  [Figure 1], [Figure 2]



 

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