“Tumour Perplex” called pilomatricoma — Report of a case with confounding chest wall mass in an adult male and its literature review

Abstract

Pilomatricoma is a rare and mostly benign tumour arising from the hair follicles, generally located in the head and neck region and less frequently on the trunk. It may be clinically confused with rather commonly occurring pathologies like sebaceous cyst, pyogenic granuloma or even malignancy. Thus, the first and foremost step towards its management is to arrive at a convincing diagnosis, and the next is to aim at its complete excision to prevent local recurrence. In this paper, we present an unusual case of an ulcerated pilomatricoma of the chest wall in an adult male. Although its gross appearance deceptively pointed towards a malignant cause, to our surprise, it ultimately proved to be benign on histological examination. Therefore, the crux of this report is to encourage the present-day surgeon to consider pilomatricoma as an important differential before undertaking any "step-of-no-return" like an avoidable radical excision and its attending morbidity. To our knowledge, such a case has not been reported in the available literature.