Riva Hannah R, Sohail Nehaa, Shalabi Mojahed Mohammad K, Kelley Benjamin, Chisholm Cary, Tolkachjov Stanislav N
Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center, El Paso, Texas, USA.
Department of Dermatology, Baylor Scott & White Medical Center, Temple, Texas, USA.
Int J Dermatol. 2025 Jun;64(6):1021-1026. doi: 10.1111/ijd.17596. Epub 2024 Dec 4.
Pilomatrix carcinoma (PMC), also known as pilomatrical carcinoma, is a rare, malignant tumor of the hair follicle that may arise from a benign pilomatricoma or de novo and carries a high risk of recurrence and metastasis. This study sought to investigate and compare surgical modalities for PMC, including reported outcomes and recurrence rates. In July 2024, a systematic review of PubMed, Embase, and Web of Science databases on surgical modalities and PMC was conducted. Randomized controlled trials and observational studies were included. The search yielded 257 articles; after the application of inclusion and exclusion criteria, 50 articles were included: four case series and 46 case reports with a total of 101 cases. There were 17 cases treated with Mohs micrographic surgery (MMS) with no recurrences. There were 84 cases treated with surgical excision with an overall recurrence rate of 34.5%. The mean follow-up time was 7.5 months for MMS and 7.6 months for surgical excision. MMS showed excellent outcomes for PMC with no recurrences compared with a recurrence rate of 34.5% for surgical excision (P < 0.0025). No recurrences or metastases were found on follow-up reported in all 17 cases treated with MMS in the literature, compared with a recurrence rate of 34.5% for the 84 cases of surgical excision. Due to the importance of early surgical intervention and attaining true negative margins to prevent recurrence and metastasis, MMS should be considered for the treatment of PMC, especially where tissue sparing is essential.
毛母质癌（PMC），也称为毛母质瘤，是一种罕见的毛囊恶性肿瘤，可起源于良性毛母质瘤或新发，具有较高的复发和转移风险。本研究旨在调查和比较PMC的手术方式，包括报告的结果和复发率。2024年7月，对PubMed、Embase和Web of Science数据库进行了关于手术方式和PMC的系统综述。纳入随机对照试验和观察性研究。检索共获得257篇文章；应用纳入和排除标准后，纳入50篇文章：4个病例系列和46个病例报告，共101例。17例接受Mohs显微外科手术（MMS）治疗，无复发。84例接受手术切除，总体复发率为34.5%。MMS的平均随访时间为7.5个月，手术切除为7.6个月。与手术切除复发率34.5%相比，MMS治疗PMC显示出无复发的优异结果（P < 0.0025）。文献中报道的17例接受MMS治疗的病例在随访中均未发现复发或转移，而84例手术切除病例的复发率为34.5%。由于早期手术干预和获得真正阴性切缘对于预防复发和转移的重要性，对于PMC的治疗应考虑采用MMS，尤其是在保留组织至关重要的情况下。
