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Pathology of Pilomatrix


Dr Sampurna Roy MD  

Dermatopathology Quiz Case  29    

Diagnosis: Pilomatrix carcinoma




Pilomatrix carcinoma is a neoplasm of low-grade malignancy.

Related post: Pilomatrixoma

Microscopic features:


The architectural features are those of a malignant neoplasm -

(i) Asymmetry and poor circumscription,

(ii) Presence of several variably shaped and sized basaloid aggregations,

(iii) Ulceration. 

The tumour is composed of pleomorphic basaloid cells with prominent nucleoli and frequent atypical mitoses accompanied by central areas with keratotic material, shadow cells, and foci of necrosis.

Tumour nests are surrounded by a desmoplastic stroma ;

There is infiltration into the adjacent tissues.


Differential diagnosis:  Should be distinguished from:

(i) Conventional pilomatrixoma and its variant  proliferating pilomatrixoma 

(ii) Matricoma ; 

(iii) Basal cell carcinoma with matrical differentiation.

Clinicians and pathologists should be aware of the occurrence of pilomatrix carcinoma because of its potential for distant metastases.

Malignant pilomatrixoma carries a high risk of metastases to the bones, lungs, and lymph nodes.

Surgical wide resection is the recommended treatment.  
Summary of findings of Pilomatrix carcinoma :  

- Larger in size, shows cytological pleomorphism ,

- Infiltrative growth pattern and

- Potential to metastasize.

Further reading

Pilomatrix carcinoma: a case report and review of the literature.

Malignant pilomatrixoma arising on the previously irradiated face: case report and literature review.

Pilomatrix carcinoma of the thoracic spine: case report and review of the literature.

Cell-cell adhesion proteins in melanocytic pilomatrix carcinoma.

Pilomatrix carcinoma arising from pilomatricoma after 10-year senescent period: Immunohistochemical analysis.

Recurrent pilomatrix carcinoma of scalp treated by electron beam radiation therapy.

Malignant pilomatrixoma of head and neck. A case report.

Malignant pilomatricoma in the upper eyelid.

Recurrent malignant pilomatrixoma invading the cranial cavity: Improved local control with adjuvant radiation.

Pilomatrix carcinoma presenting as an extra axial mass: clinicopathological features.

Pilomatrix carcinoma with visceral metastases: case report and review of the literature.




Dr Sampurna Roy  MD

Consultant  Histopathologist (Kolkata - India)







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