Case Number : Case 907 - 10th December Posted By: Guest

Basal cell carcinoma with matricial differentiation which shows some features similar to pilomatricoma

DD includes: Proliferating pilomatricoma and panfolliculoma.

Benign adnexal tumor with matrical and trichoepithelioma-like differentiation
DD:
Trichoepithelioma with matrical differentiation
Proliferating epidermal cyst with pilar differentiation
Inverted follicular keratosis with pilar differentiation
I do not thick it is malignant (manely no BCC compenet prsent)

BCC with matrical differentiation

I also favor a benign skin adnexal tumor. How about panfolliculoma.

There is differentiation towards the infundibulum, inner root sheath and germ: Trichofolliculoma versus panfolliculoma.

Trichoblastoma-like tumor with infundibular and matrical differentiation. This remembers me a letter by Hu et al.:
[url="http://www.medicaljournals.se/acta/content/?doi=10.2340/00015555-0880"]http://www.medicaljo...0/00015555-0880[/url]

Benign, would favour trichoblastoma with some differentiation towards inner root sheath. Papillary mesenchymal aggregates are against BCC.

I have read the comments and revised the images again, yes I missed the units with intimate fibroepithelial relation favoring trichoblastoma but I think there is also retraction of the stroma from the upper epithelial island on the right side (first image). Could it be BCC with juxtaposed trichoblastoma like and panfolliculoma like areas? Or there is no BCC component at all here? We need also to know what was the diagnosis of the original biopsy?

Panfolliculoma. Absolutely stunning images - congrats!

I think this is a benign trichoblastoma variant.

Panfolliculoma

Agree with panfolliculoma....this tumor seems to 'have it all' with mixed sebaceous, squamous, basaloid, and classic pilomatricoma features of matrical/trichohyaline/ghost cell differentiation.

If one doesn't believe in splitting out the term 'panfolliculoma' (or has mercy on one's clinicians/patients getting the report!), I would call it a pilomatricoma. The focal connection to the epidermis, patchy mucinous stroma, infundibulocystic squamous features, and areas of follicular differentiation (with papillary mesenchymal bodies) and limited sebaceous differentiation would not be too inconsistent with pilomatricoma.

[i]A recent (free full-text) review article (2010) presenting the wide range of differentiation and incidental histologic features in pilomatricomas seen over the years at one Indian institution, with comparison to other review articles (Dr. Hurt is listed in the article references for extra kudos to the article authors) :[/i]
[i][b] [url="http://www.ijdvl.com/article.asp?issn=0378-6323;year=2010;volume=76;issue=5;spage=543;epage=546;aulast=Simi"]Pilomatricoma: a tumor with hidden depths.[/url][/b]
[size=3][color=#000000][font=arial, helvetica, clean, sans-serif][color=#660066]Simi CM[/color], [color=#660066]Rajalakshmi T[/color], [color=#660066]Correa M[/color].
Link (free full text article): [/font][/color][/size][url="http://www.ijdvl.com/article.asp?issn=0378-6323;year=2010;volume=76;issue=5;spage=543;epage=546;aulast=Simi"]http://www.ijdvl.com...546;aulast=Simi[/url][/i]