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Case Report
Rapidly growing giant pilomatrixoma in 57-year-old Hispanic male
1 4th-year (pre-med) undergraduate student, University of California, Riverside, CA, USA
2 Plastic Reconstructive Surgeon, The Skin and Laser Treatment Institute, Pleasant Hill, CA 94523, USA
3 Dermatopathologist/Surgical Pathologist, Contra Costa Pathology, Pleasant Hill, CA 94523, USA
Address correspondence to:
Abha Soni
DO MPH, Contra Costa Pathology Associates, Pleasant Hill, CA 94523,
USA
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Article ID: 101505Z01AS2025
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Sahrawat A, Kormi T, Soni A. Rapidly growing giant pilomatrixoma in 57-year-old Hispanic male. Int J Case Rep Images 2025;16(1):90–94.ABSTRACT
Introduction: Pilomatrixomas are benign adnexal tumors arising from hair follicle matrical and cortical cells that predominantly affect the head, neck, and upper extremities in younger adults. While typically benign, challenges in treatment and management arise with atypical features such as rapid growth, size (>5 cm), and gross complexity of the tumor. Distinguishing between benign, atypical, and malignant pilomatrixomas can be challenging both clinically and pathologically, but it is crucial for ensuring appropriate surgical management.
Case Report: We present the case of a 57-year-old male with a malignant pilomatrixoma located on his forearm, clinically resembling an aggressive neoplasm, such as a dermatofibrosarcoma sarcoma, due to its large size, rapid growth, and necrotic surface. Histology revealed an adnexal neoplasm, typically benign, but with atypical features such as expansile basaloid cell proliferation and an elevated Ki-67 index, rarely reported in the literature. A thorough histopathologic evaluation confirmed the diagnosis of atypical giant pilomatrixoma.
Conclusion: This case highlights the importance of both clinical and histopathologic evaluation in accurately diagnosing and treating neoplastic processes. While the clinical presentation suggested an aggressive neoplasm, prompting rapid surgical removal, the initial histologic evaluation resembled a benign pilomatrixoma. Careful integration of clinical and pathological findings led to the diagnosis of an atypical pilomatrixoma. This case also provides insights into the surgical management of other similar lesions in future clinical scenarios.
Keywords: Adnexal tumor, Atypical pilomatrixoma, Calcifying epithelioma of Malherbe, Ghost cells, Hair follicle, Pilomatrixoma, Pilomatricoma
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Author Contributions
Aman Sahrawat - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Touraj Kormi - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Abha Soni - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Guaranter of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this article.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2025 Aman Sahrawat et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
