Ossifying pilomatricoma and a novel hypothesis for its pathogenesis

Sung, Kun-Yong; Lee, Seungkoo; Jeong, Yeonjin; Lee, Sang‐Yeul

doi:10.1097/md.0000000000028753

Cited by 6 publications

(10 citation statements)

References 39 publications

(60 reference statements)

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“…Pilomatricomas are clinically similar with or without osseous metaplasia, however, the former are firmer on palpation and have a long history of presentation. Shadow cells are observed in the histopathology of ossifying pilomatricoma [12]. The lack of basaloid cells in this case indicates a long-standing pilomatricoma with osseous metaplasia.…”

Section: Discussionmentioning

confidence: 59%

Benign Pilomatricoma With Osseous Metaplasia: A Rare Case

Bhatti¹,

Ramchandani²,

August³

et al. 2022

Cureus

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Pilomatricomas are frequently misdiagnosed benign neoplasms of the skin derived from hair matrix cells. Pilomatricomas may undergo calcification and ossification although the latter is rare and poorly documented, with only eight cases reported since 2006. We present a case of pilomatricoma with osseous metaplasia arising from the scalp in an 87-year-old female patient. She was referred by her general practitioner via the two-week cancer referral pathway, for a suspicious lesion. On examination, there was a 2 x 1cm nodule, with protruding hardened yellow material, on the right side of the patient's occipital scalp. The lump was hard, non-tender and had been present for 17 years. The surrounding area was bleeding and slightly ulcerated. A clinical diagnosis of a ruptured epidermal cyst was made, and the patient was prepared for excision under local anaesthesia. The excised lesion of 23 x 18 x 10mm with 22 x 9mm of skin was sent for histology. This revealed a partially ulcerated dermal lesion composed of islands of keratin with 'ghost cell' outlines. Foreign body granulomas, transition to mature lamellar bone, and foci of calcification were noted. There were no definite populations of basaloid cells and features of malignancy were not seen. These findings are consistent with benign pilomatricoma with osseous metaplasia. The patient was discharged 4 weeks later with satisfactory wound healing. Differentiating this tumour from other commonly encountered benign masses remains a challenge, as seen in this case which was initially misdiagnosed as a ruptured epidermal cyst.

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Section: Discussionmentioning

confidence: 59%

Benign Pilomatricoma With Osseous Metaplasia: A Rare Case

Bhatti¹,

Ramchandani²,

August³

et al. 2022

Cureus

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“…They usually have a longer clinical history and firmer consistency than conventional pilomatricomas. 5 Usually in most reported cases of ossifying pilomatricomas, there is minimal or absence of basaloid components with the only presence of shadow cells and bone formation around the shadow cells with some cases showing extra medullary hematopoiesis. 2,[5][6][7] Osseous metaplasia is a well-described type of aberrant ossification encountered in various neoplastic and non-neoplastic conditions ranging from epidermal cyst, trichilemmal cyst to chondroid syringoma and craniopharyngioma.…”

Section: Discussionmentioning

confidence: 99%

“…5 Usually in most reported cases of ossifying pilomatricomas, there is minimal or absence of basaloid components with the only presence of shadow cells and bone formation around the shadow cells with some cases showing extra medullary hematopoiesis. 2,[5][6][7] Osseous metaplasia is a well-described type of aberrant ossification encountered in various neoplastic and non-neoplastic conditions ranging from epidermal cyst, trichilemmal cyst to chondroid syringoma and craniopharyngioma. [8][9][10][11] Ossification in pilomatricoma is generally seen next to the areas of shadow cells and is thought to be a sequelae of the longstanding fibroblastic response.…”

Section: Discussionmentioning

confidence: 99%

“…Shadow cells are not pathognomonic of pilomatricomas and may be seen in a myriad of conditions like craniopharyngiomas, odontogenic tumors etc. 5 The pilomatricomas pass through 4 chronological stages viz early, fully developed, early regressive and late regressive stages depending on the duration of the lesion. 6 Early lesions are small, cystic structures containing squamoid and basaloid cells with the presence of faulty, aberrant hair matrix material in the form of shadow cells.…”

Section: Discussionmentioning

confidence: 99%

“…2 Pilomatricoma with florid osseous metaplasia, also known as ossifying pilomatricoma, is a rare and distinct variant of pilomatricoma, the pathogenesis of which is still not well understood. 5…”

Section: Introductionmentioning

confidence: 99%

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Ossifying pilomatricoma: A rare entity

Chakrabarti

2022

ACHR

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Pilomatricomas are rare benign skin adnexal tumors usually occurring in the head, neck or upper extremities of children and young adults. Ossifying pilomatricoma is a still rarer entity. Here, a case of a 22-year-old lady is reported, who presented with a firm to hard swelling in the right side of the neck. Histopathological examination of the resected specimen showed features of ossifying pilomatricoma with the formation of bone marrow elements. The patient was free of recurrence on 6-month follow-up. The case highlights a rare entity with characteristic histopathological features.

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Unusual presentation of pilomatricoma: A case report and comprehensive review of the literature

Bazargan,

Jafarzadeh,

Nobari

et al. 2023

Clinical Case Reports

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Key Clinical MessagePilomatricoma is a benign proliferative lesion of skin appendages that often affects the head, upper limbs, and lower limbs. The clinical appearance of the lesions is that of asymptomatic nodules measuring less than 3 cm. pathologically, these skin lesions show the presence of basaloid cell islands, eosinophilic cytoplasmic cells without nuclei, as well as hemorrhage and calcification. In this study, we present the case of an 8‐year‐old girl with a 5 × 5 cm skin lesion on the forearm, which lacked the typical firmness associated with pilomatricoma lesions during examination. After biopsy, the lesion was confirmed to be pilomatricoma. Furthermore, we have reviewed studies documenting pilomatricoma lesions with atypical clinical features. Based on reports of different clinical manifestations of pilomatricoma in these studies, we suggest that the clinical diagnosis of pilomatricoma should not be limited to the typical presentation of these lesions. In cases where the lesions exceed 3 cm in size, display cystic characteristics, are painful, or resemble keloids, consideration should also be given to the possibility of pilomatricoma.

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Ossifying pilomatricoma and a novel hypothesis for its pathogenesis

Cited by 6 publications

References 39 publications

Benign Pilomatricoma With Osseous Metaplasia: A Rare Case

Benign Pilomatricoma With Osseous Metaplasia: A Rare Case

Ossifying pilomatricoma: A rare entity

Unusual presentation of pilomatricoma: A case report and comprehensive review of the literature

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