Department of Dermatology, Course of Integrated Medicine, Graduate School of Medicine, Osaka University, Osaka, Japan.
J Dermatol. 2010 Aug;37(8):735-9. doi: 10.1111/j.1346-8138.2010.00887.x.
Pilomatrix carcinoma is a rare malignant counterpart of pilomatricoma. To our knowledge, only approximately 90 cases have been published in English literature. Pilomatrix carcinoma is locally aggressive and occasionally shows rapid progression infiltrating to the muscle, bone and vessels. We report a case of pilomatrix carcinoma that developed in a 38-year-old man and started to grow after a long stable period, relapsed for a short time and infiltrated into the muscle underneath. While the initial skin biopsy showed histopathological findings consistent with pilomatricoma, the recurrent tumor contained marked cellular atypia and an aggressive growth pattern. Although it is still controversial whether pilomatrix carcinoma arises de novo or through malignant transformation of a pilomatricoma, the present case might be caused by the latter process considering the patient's clinical course. beta-catenin is a downstream effecter in the canonical pathway of Wnt, acting as a signal for cell differentiation and proliferation. The characteristic nuclear staining pattern of beta-catenin in the basaloid tumor cells, which is usually observed in pilomatrix carcinoma, supported the diagnosis of pilomatrix carcinoma in the present case.
毛母质瘤是毛母质瘤的罕见恶性对应物。据我们所知，英文文献中仅约有 90 例报道。毛母质癌具有局部侵袭性，偶尔会迅速进展，浸润至肌肉、骨骼和血管。我们报告了一例发生在 38 岁男性的毛母质癌，在长时间稳定期后开始生长，短时间复发并浸润至下方肌肉。虽然初始皮肤活检显示组织病理学发现符合毛母质瘤，但复发性肿瘤含有明显的细胞异型性和侵袭性生长模式。尽管毛母质癌是从头发生还是通过毛母质瘤的恶性转化而来仍存在争议，但考虑到患者的临床过程，本例可能由后者引起。β-连环蛋白是 Wnt 经典途径中的下游效应物，作为细胞分化和增殖的信号。基底样肿瘤细胞中β-连环蛋白的特征性核染色模式，通常在毛母质癌中观察到，支持了本例毛母质癌的诊断。
