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Pilomatricoma of the breast

Case contributed by Leire Ormaetxe Albeniz
Diagnosis certain

Presentation

Painless palpable lump in the upper inner quadrant of the right breast over the last 6 months.

Patient Data

Age: 45 years
Gender: Male
mammography

The tomosynthesis and synthesized mammogram images, obtained with a skin marker indicating the location of the palpable lesion, show a round nodule with obscured margins at the upper inner quadrant of the right breast.

No fibroglandular tissue is present.

No abnormal skin thickening, nipple retraction or significant axillary lymphadenopathies can be seen.

Focused soft tissue

ultrasound

Corresponding to the area of abnormality, there is a superficial, round, hypoechoic lesion, with indistinct margins and discrete posterior acoustic shadowing at the junction of the dermis and subcutaneous fat.

Case Discussion

Based on the imaging features, the lesion was reported as BI-RADS 4 category. Therefore, the patient underwent an ultrasound-guided core needle biopsy, obtaining a histopathological diagnosis of pilomatricoma.

Pilomatricomas are benign skin tumors that arise from the hair follicles. They typically manifest as slowly-growing superficial round mobile and firm palpable lumps, being their breast location extremely rare. Due to their clinical and imaging features, they can easily be misdiagnosed as breast cancer. In such cases, the histological analysis of the lesion becomes essential for the differential diagnosis.

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