Andjela Egger1, Yumeng Li1, Mercedes E Gonzalez1. 1. Dr. Phillip Frost Department of Dermatology & Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA.
Abstract
INTRODUCTION: Giant pilomatrixomas are quite rare and can be clinically challenging to diagnose. CASE PRESENTATION: 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. CONCLUSION: 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.
INTRODUCTION: Giant pilomatrixomas are quite rare and can be clinically challenging to diagnose. CASE PRESENTATION: 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. CONCLUSION: 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.
Authors: Gian Piero Lozzi; H Peter Soyer; Julia Fruehauf; Cesare Massone; Helmut Kerl; Ketty Peris Journal: Am J Dermatopathol Date: 2007-06 Impact factor: 1.533