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BRIEF COMMUNICATION
Year : 2016  |  Volume : 8  |  Issue : 4  |  Page : 195-196  

Cutaneous hybrid tumor composed of epidermal cyst and cystic pilomatricoma: Unusual presentation in a child


1 Department of Pediatric Surgery, Penteli Children's Hospital, Penteli, Greece
2 Department of Histopathology, Sismanoglio Hospital, Marousi, Athens, Greece

Date of Web Publication28-Mar-2017

Correspondence Address:
Christos Plataras
Department of Pediatric Surgery, Penteli Children's Hospital, Ippokratous 8, 15236, Penteli
Greece
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijt.ijt_62_15

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   Abstract 

We report a rare case of cutaneous hybrid tumor composed of epidermal cyst and cystic pilomatricoma that presented in an unusual way in a child. A 14-year-old teen girl presented with a skin lesion on the inner side of the left arm, approximately at the level of the elbow. The lesion was initially observed 5 months before and was continuously increasing in size during that time resembling other benign or malignant cutaneous tumors.

Keywords: Child, epidermal cyst, Malherbe epithelioma, pilomatricoma


How to cite this article:
Lamprou K, Plataras C, Chorti M, Christianakis E. Cutaneous hybrid tumor composed of epidermal cyst and cystic pilomatricoma: Unusual presentation in a child. Int J Trichol 2016;8:195-6

How to cite this URL:
Lamprou K, Plataras C, Chorti M, Christianakis E. Cutaneous hybrid tumor composed of epidermal cyst and cystic pilomatricoma: Unusual presentation in a child. Int J Trichol [serial online] 2016 [cited 2020 Oct 27];8:195-6. Available from: https://www.ijtrichology.com/text.asp?2016/8/4/195/203173


   Case Presentation Top


We report the case of a 14-year-old teen girl who presented with a skin lesion on the inner side of the left arm, approximately at the level of the elbow [Figure 1]. The lesion was initially observed 5 months before and was continuously increasing in size during that period. The history and the clinical examination of the patient did not reveal any other pathological background.
Figure 1: Skin lesion of the left forea

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Upon examination, the lesion had a cystic, semi-transparent, fluid-filled, pedunculated appearance. At its inside, multiple, stony-hard, nodule-like structures were observed. The approximate dimensions of the lesion were 30 mm × 20 mm. During palpation, the patient did not refer any discomfort or pain.

The magnetic resonance imaging with and without the use of contrast media demonstrated a well-demarcated, broadly based mass with centrally solid and peripherally cystic structures [Figure 2]. That abnormal structure did not infiltrate the muscular or the bone tissues though. There was also an afferent vessel, originating from the basilar artery. The differential diagnosis based on the clinical finding of rapid growth included a subcutaneous sarcoma (fibroma-like or pseudogranulomatous), but the radiologic findings were more suggestive of a benign subcutaneous ring-like granuloma or a subcutaneous fibroma.
Figure 2: Magnetic resonance imaging of the skin lesion. Well-demarcated mass with centrally solid and peripherally cystic structures

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The lesion was surgically excised, and surgical exploration of the underlying tissue did not reveal any local infiltration or spread.

Histopathology showed a tumorous formation (diameter ~ 3 cm) of subcutaneous origin consistent with the morphology of calcified Malherbe's epithelioma. It was also consisted of dermoid cysts and dilated lymphatic vessels. No malignant cells were found [Figure 3] and [Figure 4].
Figure 3: Histologic appearance of the lesion. Pilomatrixoma is located in the lower, whereas epidermal inclusion cyst is found in the upper right part of the histology slide

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Figure 4: Histologic appearance of the central lesion suggestive of pilomatrixoma

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Cutaneous hybrid tumor composed of epidermal cyst and cystic pilomatricoma as in our case is very rare.[1] Pilomatricoma (pilomatrixoma), or calcifying epithelioma of Malherbe, is a tumor with differentiation toward hair cells, particularly hair cortex cells. Pilomatricoma occurs usually as a solitary lesion. The face and the upper extremities are the most common sites. In general, the tumor varies in diameter from 0.5 to 3.0 cm, but it may be as large as 5 cm. The tumors may arise in persons of any age, but about 40% of them arise in children younger than 10 years of age, and about 60% in persons in the first two decades of life.[2]

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

 
   References Top

1.
Terada T. Cutaneous hybrid tumor composed of epidermal cyst and cystic pilomatricoma expressing p53 and high Ki-67 labeling. Int J Clin Exp Pathol 2013;6:1187-9.  Back to cited text no. 1
    
2.
Tamer A, Del Priore J, Seykora J. Tumors of the epidermal appendages. In: Lever's Histopathology of the Skin. 10th ed. Philadelphia, Lippincott Williams & Wilkins; 2009. p. 864.  Back to cited text no. 2
    


    Figures

  [Figure 1], [Figure 2], [Figure 3], [Figure 4]



 

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