A 58-year-old woman presented with a pilomatrix carcinoma on the right knee. The tumor developed at the site of a previous lesion that had been present since she was 30 years old. Histologic study showed the presence of basaloid cells with numerous atypical mitoses, shadow cells, and calcification. After several surgical excisions, the tumor mass infiltrated the subcutaneous tissue, muscle, and bone, resulting in inguinal lymph node and pulmonary metastasis. We also review the literature and comment on the histopathologic differences from other cutaneous tumors.
Composite cutaneous hemangioendothelioma (HE) is the most recently described variant of the lesions known as HEs. It is characterized by a mixture of histologic patterns, namely, epithelioid HE, retiform HE, and spindle cell hemangioma. We report a new case of this rare tumor located on the back of a 23-year-old woman. This neoplasm is considered to be of borderline or low-grade malignancy, because despite its frequency it rarely metastasizes.
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