White Christopher, Farsi Maheera, Esguerra David, Miller Richard
All authors are with HCA Healthcare/University of South Florida Morsani College of Medicine at Largo Medical Center Department of Dermatology in Largo, Florida.
J Clin Aesthet Dermatol. 2020 Jun;13(6):40-42. Epub 2020 Jun 1.
Pilomatrix carcinoma is a rare malignancy stemming from aberrant proliferation of matrical cells found in developing hair. This neoplasm demonstrates a bimodal age distribution and a proclivity for developing on the head or neck. Clinically, a firm, painless, violaceous nodule with overlying ulceration is commonly described. Pilomatrix carcinoma is considered a variable-grade malignancy that tends to be locally aggressive, though metastatic disease occurs in 10 to 16 percent of cases. Mortality rates range from 7 to 9 percent. Although there is no definitive treatment protocol, surgical intervention in the form of local excision or via Mohs micrographic surgery can be considered, with radiotherapy adopted as an effective alternative for nonsurgical, recurrent, or metastatic disease. Here, we describe the case of a 62-year-old man who presented for evaluation of a red, enlarging lesion on his forehead which became tender and started to bleed shortly before the patient presented to our clinic. The patient was ultimately referred to a tertiary care center for surgical excision and, at the time of this pubilcation, has been tumor-free for more than one year. This case of a rare and often unconsidered neoplasm underscores the importance of clinical suspicion and close patient follow up to prevent local recurrence, metastasis, and death.
毛母质癌是一种罕见的恶性肿瘤，起源于发育中的毛发中母细胞的异常增殖。这种肿瘤呈现双峰年龄分布，且倾向于发生在头部或颈部。临床上，通常描述为一个质地坚硬、无痛、紫罗兰色且伴有表面溃疡的结节。毛母质癌被认为是一种分级可变的恶性肿瘤，往往具有局部侵袭性，不过10%至16%的病例会发生转移性疾病。死亡率在7%至9%之间。虽然没有明确的治疗方案，但可以考虑采用局部切除或莫氏显微外科手术形式的手术干预，对于非手术、复发性或转移性疾病，放射治疗可作为一种有效的替代方法。在此，我们描述了一名62岁男性的病例，他前来就诊是为了评估前额上一个红色且不断增大的病变，该病变在患者前来我们诊所前不久变得疼痛并开始出血。患者最终被转诊至三级医疗中心进行手术切除，在撰写本文时，已无瘤超过一年。这个罕见且常被忽视的肿瘤病例凸显了临床怀疑以及密切随访患者以预防局部复发、转移和死亡的重要性。
