Giant pilomatricoma on the upper back

Deepak Jakhar¹ , Chander Grover¹ , Sonal Sharma²

¹ Department of Dermatology and STD, University College of Medical Sciences and GTB Hospital, New Delhi, India
² Department of Pathology, University College of Medical Sciences and GTB Hospital, New Delhi, India

Correspondence Address:
Chander Grover
Department of Dermatology and STD, University College of Medical Sciences and GTB Hospital, Dilshad Garden, New Delhi - 110 095
India

A 14-year-old boy presented with a slightly painful swelling on the upper back since 6 years of age. On clinical examination, a firm, 6 × 4 cm, bluish to erythematous tender swelling on left upper back overlying the scapula, was seen [Figure - 1]a. It was freely mobile with slightly corrugated surface showing multiple facets (tent sign). Ultrasound showed hyperechoic margins with an echogenic center and absence of any calcification. Histological evaluation demonstrated a tumorous growth with lobules lined by basaloid cells with abrupt transition to eosinophilic material in the centre. On high-power view, keratinized cells with empty appearing “ghost cells” having shadows of nuclei within were seen [Figure - 1]b. There was minimal background inflammation with absence of any focal calcification or giant cell formation. On the basis of clinical, radiological and histopathological features, giant pilomatricoma was diagnosed and was surgically excised.

Figure 1: (a) A firm bluish-red swelling on the left side of upper back. Note the corrugated surface with multiple facets (tent sign). (b) Higher power view showing keratinised cells with empty appearing ‘ghost cells’ having shadows of nuclei within. (H&Ex 400)

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form, the legal guardian has given his consent for images and other clinical information to be reported in the journal. The guardian understands that names and initials will not be published and due efforts will be made to conceal identity, but anonymity cannot be guaranteed.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.