Resumen

CALDERON VALDERRAMA, Carlos Andrés et al. Pilomatrixcarcinoma in an Adult Patient with Axillary Lymph Node Involvement as a Rarely Occurring Entity: Case Report. Rev. Fac. Med. (Méx.) [online]. 2025, vol.68, n.2, pp.38-43.  Epub 20-Jun-2025. ISSN 2448-4865.  https://doi.org/10.22201/fm.24484865e.2025.68.2.04.

Pilomatrixcarcinoma is a rare malignant tumor that originates in the matrix of the hair follicle. It represents an aggressive form of pilomatrixoma, which typically has a benign course and manifests as a slow-growing, painless mass. In contrast, its malignant variant is characterized by aggressive behavior, with a high probability of local recurrence and metastasis.

We present the case of a male patient who sought medical attention for a palpable mass in the dorsal thoracic region, along the posterior axillary line, accompanied by ulceration, foul-smelling discharge, and occasional bleeding. On physical examination, a 20 × 15 cm tumor was identified in the right infrascapular region of the back. Imaging studies were performed, and computed tomography revealed a large soft tissue lesion in the right dorsal region, extending towards the posterior axillary line, along with ipsilateral lymph node involvement.

The patient underwent wide excision of the lesion and received chemotherapy cycles with cisplatin and 5-FU. A subsequent right axillary ultrasound confirmed persistent lymph node involvement, leading to lymph node dissection. After completing chemotherapy, the annual follow-up confirmed disease remission.

The definitive diagnosis is typically established through histopathological examination, which identifies specific malignant tumor characteristics, distinguishing it from benign pilomatrixoma. While pilomatrixoma is more common in younger patients, as demonstrated in this case, its occurrence in adults can exhibit a more aggressive, expansive, and infiltrative pattern.

A thorough understanding of this tumor’s biological behavior is essential for accurate clinical evaluation. Imaging studies, tumor classification, and characterization play a crucial role in determining the therapeutic approach and long-term follow-up of this rare entity.

Palabras llave : Pilomatrixoma; pilomatrixcarcinoma; pilomatricoma; Malherbe’s tumor; axillary ultrasound; lymph node involvement.

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