Aggressive Pilomatrixoma of the Scalp in a Geriatric Patient: A Rare Occurrence
Pilomatrixoma is a benign cutaneous adnexal neoplasm that arises from the hair matrix. This lesion is typically observed in the first two decades of life, with most cases occurring before the age of 20. However, it is rare in the elderly. While aggressive and malignant variants of pilomatrixoma ex...
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| Format: | Article |
| Language: | English |
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JCDR Research and Publications Private Limited
2023-09-01
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| Series: | Journal of Clinical and Diagnostic Research |
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| Online Access: | https://www.jcdr.net/articles/PDF/18426/66420_CE[Ra1]_F(SS)_PF1(AP_PrG_SL)_QC(KK_SL)_PFA(AP_KM)_PN(KM).pdf |
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| author | Rakesh Rajiv Patkar Vicky Jain Shilpa Mishra |
| author_facet | Rakesh Rajiv Patkar Vicky Jain Shilpa Mishra |
| author_sort | Rakesh Rajiv Patkar |
| collection | DOAJ |
| description | Pilomatrixoma is a benign cutaneous adnexal neoplasm that arises from the hair matrix. This lesion is typically observed in the
first two decades of life, with most cases occurring before the age of 20. However, it is rare in the elderly. While aggressive
and malignant variants of pilomatrixoma exist, they are rarely reported compared to their benign counterparts. In this case, we
present an instance of aggressive pilomatrixoma in a 90-year-old female. The patient exhibited a large ulceroproliferative growth
on the scalp. A preliminary biopsy was performed, followed by wide local excision. Both the biopsy and excision specimens
exhibited characteristics of pilomatrixoma, with a focal infiltrative growth pattern and moderate nuclear atypia. Features indicative
of malignancy, such as geographic necrosis, brisk mitosis, atypical mitosis, vascular invasion, and perineural invasion, were not
observed. Therefore, the diagnosis of aggressive pilomatrixoma was made. Wide local excision and subsequent skin grafting
were conducted, with no involvement of deeper subcutaneous tissue and intact pericranium. The patient is currently faring well
during follow-up. This case underscores the importance of meticulous histopathological examination for distinguishing aggressive
variants, as they carry a higher risk of recurrence and aid in distinguishing aggressive pilomatrixoma from carcinoma. Failure to
recognise the aggressive variant may result in inadequate management. |
| first_indexed | 2024-03-11T20:55:58Z |
| format | Article |
| id | doaj.art-9b56ba7b18594137bf0e509f2d001576 |
| institution | Directory Open Access Journal |
| issn | 2249-782X 0973-709X |
| language | English |
| last_indexed | 2024-03-11T20:55:58Z |
| publishDate | 2023-09-01 |
| publisher | JCDR Research and Publications Private Limited |
| record_format | Article |
| series | Journal of Clinical and Diagnostic Research |
| spelling | doaj.art-9b56ba7b18594137bf0e509f2d0015762023-09-30T10:07:40ZengJCDR Research and Publications Private LimitedJournal of Clinical and Diagnostic Research2249-782X0973-709X2023-09-011709010310.7860/JCDR/2023/66420.18426Aggressive Pilomatrixoma of the Scalp in a Geriatric Patient: A Rare OccurrenceRakesh Rajiv Patkar0Vicky Jain1Shilpa Mishra2Head and Consultant Pathologist, Department of Histopathology, Microcraft-Oncquest Laboratories Limited, Mumbai, Maharashtra, India.Consultant, Department of Plastic Surgery, The Esthetique Clinique, Mumbai, Maharashtra, India.Director, Department of Histopathology, Microcraft-Oncquest laboratories Limited, Mumbai, Maharashtra, India.Pilomatrixoma is a benign cutaneous adnexal neoplasm that arises from the hair matrix. This lesion is typically observed in the first two decades of life, with most cases occurring before the age of 20. However, it is rare in the elderly. While aggressive and malignant variants of pilomatrixoma exist, they are rarely reported compared to their benign counterparts. In this case, we present an instance of aggressive pilomatrixoma in a 90-year-old female. The patient exhibited a large ulceroproliferative growth on the scalp. A preliminary biopsy was performed, followed by wide local excision. Both the biopsy and excision specimens exhibited characteristics of pilomatrixoma, with a focal infiltrative growth pattern and moderate nuclear atypia. Features indicative of malignancy, such as geographic necrosis, brisk mitosis, atypical mitosis, vascular invasion, and perineural invasion, were not observed. Therefore, the diagnosis of aggressive pilomatrixoma was made. Wide local excision and subsequent skin grafting were conducted, with no involvement of deeper subcutaneous tissue and intact pericranium. The patient is currently faring well during follow-up. This case underscores the importance of meticulous histopathological examination for distinguishing aggressive variants, as they carry a higher risk of recurrence and aid in distinguishing aggressive pilomatrixoma from carcinoma. Failure to recognise the aggressive variant may result in inadequate management.https://www.jcdr.net/articles/PDF/18426/66420_CE[Ra1]_F(SS)_PF1(AP_PrG_SL)_QC(KK_SL)_PFA(AP_KM)_PN(KM).pdfcutaneous adnexal tumoursskin graftingtumours of hair matrix |
| spellingShingle | Rakesh Rajiv Patkar Vicky Jain Shilpa Mishra Aggressive Pilomatrixoma of the Scalp in a Geriatric Patient: A Rare Occurrence Journal of Clinical and Diagnostic Research cutaneous adnexal tumours skin grafting tumours of hair matrix |
| title | Aggressive Pilomatrixoma of the Scalp in a Geriatric Patient: A Rare Occurrence |
| title_full | Aggressive Pilomatrixoma of the Scalp in a Geriatric Patient: A Rare Occurrence |
| title_fullStr | Aggressive Pilomatrixoma of the Scalp in a Geriatric Patient: A Rare Occurrence |
| title_full_unstemmed | Aggressive Pilomatrixoma of the Scalp in a Geriatric Patient: A Rare Occurrence |
| title_short | Aggressive Pilomatrixoma of the Scalp in a Geriatric Patient: A Rare Occurrence |
| title_sort | aggressive pilomatrixoma of the scalp in a geriatric patient a rare occurrence |
| topic | cutaneous adnexal tumours skin grafting tumours of hair matrix |
| url | https://www.jcdr.net/articles/PDF/18426/66420_CE[Ra1]_F(SS)_PF1(AP_PrG_SL)_QC(KK_SL)_PFA(AP_KM)_PN(KM).pdf |
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