Pilomatrixoma in Breast

Abstract

A 47 years old, male, referred node in left breast, little painful to handling, 2 months ago. Reporting trauma in thoracic region 6 months ago, when suffered fall from height. Personal and family history negative. Physical examination: node of 1.5 cm, hardened in region to ids 0.5 cm of the areola and not linked to axilary lynph nodes. Laboratory tests: mammography birads iv ace of costs of node with limits indistict + microcalcifications inside and ultrasonography showing lobulated node, heterogeneous, posterior acoustic shadowing producer and with increased vascularization. Birads category iv. Submitted to excisional biopsy and the freezing of examination showed up negative for malignant neoplasm and is confirmed diagnosis of pilomatrixoma. Pilomatrixomas are uncommon benign skin neoplasms arising from the hair follicle matrix. They occur more commonly in children than adults. Most originate on the head, neck, or upper extremities, less commonly on the trunk or lower extremities, and very infrequently in the breast. Despite a very low propensity for malignant degeneration, surgical excision is the treatment of choice for pilomatrixomas, mainly for symptomatic and cosmetic reasons in. Given the age, location, and low chance of malignant degeneration, conservative management may be considered in rare case of pilomatrixoma of the adult breast. Developing in the subcutaneous tissue and arising from the matrix cells of the hair bulb, these benign tumors usually develop during the first two decades of life and have been very rarely described to degenerate to pilomatrixcarcinoma. Commonly found on the head with the cheek being a frequent location, followed by the neck and upper extremities in decreasing frequency. Pilomatrixomas are very rarely found in the breast. Surgery is curative and reoccurence after excision is rare. A differential diagnosis of a superficial breast lesion includes seborrheic keratosis, dermal nevus, epidermal inclusion cyst, and basal cell carcinoma. Much less frequently, dermal or subdermal lesions can represent or hemangioma breast carcinoma. We suggest a conservative approach of interval follow-up for any small superficial breast mass with benign imaging characteristics. Such masses can be assigned into a BI-RADS 3 category without a pathologic diagnosis or following a benign biopsy result to ensure stability over time. Also, conservative management can be considered in cases of pilomatrixoma of the adult breast. Although, most advise surgical excision of the tumor, especially in a pediatric population, an asymptomatic pilomatrixoma cosmetically acceptable to the patient seems safe to monitor with imaging as there is very low chance of malignant degeneration. CONCLUSIONS: pilomatrixomas represent table with benign neoplasm of rare differential diagnosis with breast cancer. Be construed as malignant neoplasm in due to find the fna keratinous material. The treatment is the simple exeresis of the tumor. A recurrence is rarely observed. When multiple recurrences are observed, one most make differential diagnosis of a pilomatrix carcinoma. Rarely may be associated with myotonic dystrophy and the rubinstein-taybi syndrome.