Yadia Sanjay, Randazzo Ciro G, Malik Sajjad, Gressen Eric, Chasky Moshe, Kenyon Lawrence C, Ratliff John K
Department of Neurological Surgery, Anatomy and Cell Biology, Thomas Jefferson University, Philadelphia, Pennsylvania 19107, USA.
J Spinal Cord Med. 2010;33(3):272-7. doi: 10.1080/10790268.2010.11689707.
Pilomatrixoma is a common head and neck neoplasm in children. Its malignant counterpart, pilomatrix carcinoma, is rare and found more often in men.
Case report of a 21-year-old man with pilomatrixoma of the thoracic spine that underwent malignant degeneration to pilomatrix carcinoma.
The appearance of a painless mobile axillary mass was followed by severe back pain 1 year later. Imaging revealed a compression fracture at the T5 level. The patient underwent resection of the axillary mass and spinal reconstruction of the fracture; the pathology was consistent with synchronous benign pilomatrixomas. Three months later he presented with a recurrence of the spinal lesion and underwent further surgical resection; the pathology was consistent with pilomatrix carcinoma. He received adjuvant radiotherapy and at his 1-year follow-up examination had no sign of recurrence.
CONCLUSION/CLINICAL RELEVANCE: Pilomatrix carcinoma involving the spine is a rare occurrence. It has a high incidence of local recurrence, and wide excision may be necessary to reduce this risk. Radiotherapy may be a helpful adjuvant therapy. Clinicians should be aware of this entity because of its potential for distant metastasis.
毛母质瘤是儿童常见的头颈部肿瘤。其恶性对应物毛母质癌罕见，且在男性中更常见。
报告1例21岁男性胸椎毛母质瘤发生恶性转化为毛母质癌的病例。
出现无痛性可移动腋窝肿块，1年后出现严重背痛。影像学检查显示T5水平压缩性骨折。患者接受了腋窝肿块切除和骨折的脊柱重建；病理结果与同步性良性毛母质瘤一致。3个月后，他出现脊柱病变复发并接受了进一步手术切除；病理结果与毛母质癌一致。他接受了辅助放疗，在1年的随访检查中没有复发迹象。
结论/临床意义：累及脊柱的毛母质癌罕见。其局部复发率高，可能需要广泛切除以降低这种风险。放疗可能是一种有用的辅助治疗。临床医生应了解这种疾病，因为它有远处转移的可能性。
