Work

Diagnostic challenges of giant cervical pilomatrixoma mimicking malignancy: case report and focused literature review

Year: 2026

Type: article

Abstract: Pilomatrixoma is a benign skin adnexal tumor arising from the hair-follicle matrix. While typically small and slowly growing, rare "giant" variants (>5 cm)-especially in the cervical region-may clinically and radiologically mimic malignant masses, posing a significant diagnostic challenge. We report a case of a 29-year-old male presenting with a solitary, firm, subcutaneous mass (~6 cm) in the left anterior cervical region, which enlarged rapidly over 6 months without pain or systemic symptoms. Contrast-enhanced CT revealed a well-defined, heterogeneous subcutaneous lesion without muscular or vascular invasion. Core needle biopsy (CNB) supported a diagnosis of pilomatrixoma. The mass was completely excised under IV sedation and local anesthesia. Histopathology confirmed classic pilomatrixoma features (basaloid cells, shadow cells, foreign-body giant cell reaction). At one-year follow-up the patient was disease-free, and scar outcome was excellent. This case underscores the importance of including giant pilomatrixoma in the differential diagnosis of large cervical soft-tissue masses. Histopathological examination remains essential for definitive diagnosis, while CNB can guide preoperative planning. Complete surgical excision yields excellent outcomes with minimal morbidity, avoiding overtreatment for suspected malignancy.

Source: Frontiers in Medicine

DOI: 10.3389/fmed.2026.1758413

Authors: Horatiu Urechescu, Marius Pricop, Flavia Zara, Raluca Maria Closca, Felicia Streian

Institution: Victor Babeș University of Medicine and Pharmacy Timișoara

Language: English

Topic: Cancer and Skin Lesions

Subfield: Dermatology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $3,801