Egger Andjela, Li Yumeng, Gonzalez Mercedes E
Dr. Phillip Frost Department of Dermatology & Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA.
Skin Appendage Disord. 2020 Jul;6(4):240-243. doi: 10.1159/000507641. Epub 2020 Jun 3.
Giant pilomatrixomas are quite rare and can be clinically challenging to diagnose.
Here, we report a case of a rapidly growing mass on the shoulder of a 12-year-old previously healthy boy. The lesion on his right shoulder appeared as a painless, pink-blue-colored solitary mass that started 6 months ago and rapidly enlarged to 4.5 × 6 cm in size. Previous biopsy results were inconclusive, showing only hypercellular spindle cell proliferation in a collagenous stroma. There was concern for malignancy versus mixed lymphatic venous malformation or benign soft tissue tumor. An excisional biopsy was done and demonstrated features of a pilomatrixoma. Complete surgical removal with clear margins was curative.
Diagnosis and management of rapidly enlarging skin lesions in children can be difficult for clinicians and dermatopathologists. Excisional biopsy can be both diagnostic and therapeutic. A timely exclusion of malignancy is of utmost importance.
巨大毛母质瘤十分罕见，临床诊断颇具挑战性。
在此，我们报告一例12岁既往健康男孩肩部迅速生长肿物的病例。他右肩部的病变表现为一个无痛的粉蓝色孤立肿物，始于6个月前，迅速增大至4.5×6厘米大小。先前的活检结果不明确，仅显示在胶原性基质中有细胞增多的梭形细胞增殖。存在恶性肿瘤与混合性淋巴管静脉畸形或良性软组织肿瘤的鉴别问题。进行了切除活检，结果显示为毛母质瘤特征。完整切除且切缘清晰可治愈。
对于临床医生和皮肤病理学家而言，诊断和处理儿童迅速增大的皮肤病变可能存在困难。切除活检兼具诊断和治疗作用。及时排除恶性肿瘤至关重要。
