Pilomatrical carcinoma - Rxharun

Pilomatrical carcinoma

Pilomatrical carcinoma is a rare and aggressive malignant tumor that originates from hair follicle matrix cells. It accounts for less than 1% of all cutaneous malignancies, and its diagnosis can be challenging due to its low incidence and variable clinical presentation. In this article, we will provide a comprehensive list of definitions and types of biometrical carcinoma and explain the details of each. Pilomatrical carcinoma is a malignant tumor that arises from the matrix cells of the hair follicles. It can occur anywhere on the body but most commonly affects the head and neck region. It is a rare malignancy and accounts for less than 1% of all cutaneous malignancies.

Pilomatrical carcinoma, also known as pilomatrix carcinoma, is a rare type of skin cancer that arises from the hair follicles. It typically presents as a slow-growing, painless nodule or mass on the skin, and can occur at any age, although it is more commonly diagnosed in adults over the age of 50. While pilomatrical carcinoma is considered a low-grade malignancy, it has the potential to spread to nearby lymph nodes and other organs if left untreated.

Types:

There are several histological types of pilomatrical carcinoma, which are as follows:

  • a. Classical type: This is the most common histological type and is characterized by the presence of squamous and basaloid cells arranged in nests and cords. The tumor cells can show keratinization and the formation of cysts.
  • b. Clear cell type: This type is characterized by the presence of clear cells that have abundant cytoplasm and centrally located nuclei. The clear cell type is associated with a better prognosis than the classical type.
  • c. Pilomatrixoma-like type: This type is characterized by the presence of basaloid cells arranged in lobules, surrounded by eosinophilic keratin material.
  • d. Trichilemmal carcinoma-like type: This type is characterized by the presence of squamous cells with abundant keratinization and the absence of basaloid cells.

Causes

Most common causes of pilomatrical carcinoma.

  1. Age: Pilomatrical carcinoma is more commonly diagnosed in older individuals, with the majority of cases occurring in individuals over the age of 50.
  2. Gender: Pilomatrical carcinoma is more common in females than males.
  3. Race: There is some evidence to suggest that pilomatrical carcinoma may be more common in individuals of Hispanic or African American descent.
  4. Genetic predisposition: Pilomatrical carcinoma may be associated with genetic mutations, such as those seen in the TP53 and CTNNB1 genes.
  5. Exposure to radiation: Exposure to ionizing radiation, such as that used in radiation therapy, has been linked to an increased risk of developing pilomatrical carcinoma.
  6. Ultraviolet radiation: Chronic exposure to ultraviolet radiation, such as that from the sun or tanning beds, has been linked to an increased risk of developing pilomatrical carcinoma.
  7. Immunosuppression: Individuals with weakened immune systems, such as those with HIV/AIDS or who have received organ transplants, may be at an increased risk of developing pilomatrical carcinoma.
  8. Chemical exposure: Exposure to certain chemicals, such as arsenic and polycyclic aromatic hydrocarbons (PAHs), has been linked to an increased risk of developing pilomatrical carcinoma.
  9. Inflammatory skin conditions: Chronic inflammatory skin conditions, such as acne, may increase the risk of developing pilomatrical carcinoma.
  10. Trauma to the skin: Repeated trauma to the skin, such as that caused by chronic irritation or scratching, may increase the risk of developing pilomatrical carcinoma.
  11. Family history: A family history of pilomatrical carcinoma may increase an individual’s risk of developing the disease.
  12. Xeroderma pigmentosum: Xeroderma pigmentosum is a genetic disorder that increases an individual’s sensitivity to ultraviolet radiation and can increase the risk of developing pilomatrical carcinoma.
  13. Basal cell nevus syndrome: Basal cell nevus syndrome is a genetic disorder that increases an individual’s risk of developing various types of skin cancers, including pilomatrical carcinoma.
  14. Osteosarcoma: Individuals who have previously been diagnosed with osteosarcoma, a type of bone cancer, may be at an increased risk of developing pilomatrical carcinoma.
  15. Gorlin syndrome: Gorlin syndrome is a genetic disorder that increases an individual’s risk of developing various types of cancer, including pilomatrical carcinoma.
  16. Cowden syndrome: Cowden syndrome is a genetic disorder that increases an individual’s risk of developing various types of cancer, including pilomatrical carcinoma.
  17. Muir-Torre syndrome: Muir-Torre syndrome is a genetic disorder that increases an individual’s risk of developing various types of cancer, including pilomatrical carcinoma.
  18. Diabetes: Some studies suggest that individuals with diabetes may be at an increased risk of developing pilomatrical carcinoma.
  19. Obesity: Obesity has been linked to an increased risk of developing several types of cancer, including pilomatrical carcinoma.
  20. Hormonal changes: Some studies suggest that hormonal changes, such as those seen during pregnancy, may increase the risk of developing pilomatrical carcinoma.

Symptoms

The symptoms of pilomatrical carcinoma can vary depending on the location and size of the tumor, as well as the stage of the disease. However, there are several common symptoms that are associated with this type of cancer. Below, we will discuss the top 20 symptoms of pilomatrical carcinoma in detail.

  1. Skin nodule or mass: The most common symptom of pilomatrical carcinoma is the presence of a firm, painless nodule or mass on the skin. This can be located anywhere on the body, but is most commonly found on the head, neck, or upper extremities.
  2. Slow growth: Pilomatrical carcinoma is a slow-growing cancer, and the nodule or mass may have been present for months or years before it is diagnosed.
  3. Skin ulceration: In some cases, the tumor may become ulcerated, which can cause bleeding or discharge from the skin.
  4. Skin discoloration: The skin overlying the tumor may become discolored, appearing pink, red, or purple in color.
  5. Skin texture changes: The skin overlying the tumor may become thickened or rough in texture, and may feel different than the surrounding skin.
  6. Skin indentation: As the tumor grows, it may cause an indentation or depression in the skin.
  7. Skin irritation: The tumor may cause irritation or itching in the surrounding skin.
  8. Enlarged lymph nodes: If the tumor has spread to nearby lymph nodes, they may become enlarged and tender to the touch.
  9. Pain: While pilomatrical carcinoma is typically painless, in some cases it may cause discomfort or pain.
  10. Limited mobility: If the tumor is located in an area where there is limited mobility, such as the scalp or face, it may cause difficulty with movement.
  11. Facial asymmetry: If the tumor is located on the face, it may cause facial asymmetry or distortion.
  12. Vision changes: If the tumor is located near the eyes, it may cause vision changes or visual disturbances.
  13. Hearing changes: If the tumor is located near the ears, it may cause hearing changes or hearing loss.
  14. Difficulty swallowing: If the tumor is located in the neck or throat, it may cause difficulty swallowing.
  15. Hoarseness: If the tumor is located near the vocal cords, it may cause hoarseness or changes in the voice.
  16. Numbness or tingling: If the tumor is located near a nerve, it may cause numbness or tingling in the surrounding area.
  17. Fatigue: As with many types of cancer, pilomatrical carcinoma can cause fatigue or a general feeling of tiredness.
  18. Weight loss: In some cases, pilomatrical carcinoma may cause unexplained weight loss.
  19. Fever: If the tumor has spread to other parts of the body, it may cause a fever or other systemic symptoms.
  20. Night sweats: If the tumor has spread to other parts of the body, it may cause night sweats or other systemic symptoms.

Diagnosis

Diagnostic tests and procedures used for diagnosing PC.

  1. Physical examination: A doctor will examine the skin for any abnormalities, such as lumps or growths.
  2. Biopsy: A small sample of the affected tissue is taken for examination under a microscope to determine if cancer cells are present.
  3. Immunohistochemistry: This test uses antibodies to identify specific proteins in cancer cells, which can help confirm the diagnosis.
  4. Fine-needle aspiration biopsy: A thin needle is inserted into the tumor to extract a small sample of cells for examination under a microscope.
  5. CT scan: A series of X-rays are taken to create detailed images of the inside of the body, which can help detect the size and location of the tumor.
  6. MRI scan: Magnetic fields and radio waves are used to create detailed images of the body, which can help determine the extent of the tumor.
  7. PET scan: A radioactive substance is injected into the body, and a scanner is used to create images that can show the spread of cancer cells.
  8. Ultrasound: High-frequency sound waves are used to create images of the inside of the body, which can help detect the size and location of the tumor.
  9. Dermoscopy: A handheld instrument with a magnifying lens and a light source is used to examine the skin for abnormalities.
  10. Biopsy with frozen section analysis: A small sample of the affected tissue is taken for examination under a microscope while the patient is still in surgery to determine if the tumor is malignant.
  11. Excisional biopsy: The entire tumor is removed and sent for examination under a microscope to determine if cancer cells are present.
  12. Punch biopsy: A small, circular tool is used to remove a sample of the affected tissue for examination under a microscope.
  13. Shave biopsy: A thin slice of tissue is shaved off the surface of the skin for examination under a microscope.
  14. Sentinel lymph node biopsy: A radioactive substance is injected into the tumor, and a surgeon removes the first lymph node that the substance travels to in order to determine if cancer cells have spread.
  15. Complete blood count: This test measures the levels of various blood cells in the body and can help detect any abnormalities.
  16. Blood chemistry tests: These tests measure the levels of various substances in the blood, such as electrolytes, proteins, and enzymes, which can help detect any abnormalities.
  17. Electrocardiogram (ECG): This test measures the electrical activity of the heart and can detect any abnormalities.
  18. Chest X-ray: An X-ray of the chest can help detect any abnormalities in the lungs or surrounding tissue.
  19. Bone scan: A small amount of radioactive material is injected into the body, and a scanner is used to create images of the bones, which can help detect any abnormalities.
  20. Endoscopy: A thin, flexible tube with a camera is inserted into the body to examine the inside of the body for any abnormalities.

Treatment

Treatment options for PC depend on several factors, including the size and location of the tumor, the patient’s age and general health, and the tumor’s stage.  Treatments for pilomatrical carcinoma, including surgical and non-surgical options.

  1. Surgery: The most common treatment for PC is surgical removal of the tumor. Depending on the size and location of the tumor, the surgeon may perform a wide excision, which involves removing a margin of healthy tissue around the tumor to ensure complete removal. In some cases, the surgeon may need to remove nearby lymph nodes to check for the spread of cancer.
  2. Mohs micrographic surgery: This is a specialized surgical technique that involves removing the tumor layer by layer and examining each layer under a microscope to ensure complete removal while preserving as much healthy tissue as possible.
  3. Radiation therapy: Radiation therapy involves using high-energy radiation to destroy cancer cells. It may be used alone or in combination with surgery for PC that cannot be completely removed surgically.
  4. Chemotherapy: Chemotherapy involves using drugs to kill cancer cells. It is usually reserved for advanced PC or cases where the cancer has spread to other parts of the body.
  5. Targeted therapy: Targeted therapy involves using drugs that specifically target cancer cells’ molecular and genetic abnormalities, thereby causing less harm to healthy cells.
  6. Immunotherapy: Immunotherapy involves using drugs that stimulate the patient’s immune system to recognize and attack cancer cells. It is a newer treatment option that shows promise in treating PC.
  7. Cryosurgery: Cryosurgery involves freezing the tumor with liquid nitrogen to destroy cancer cells. It is a less invasive alternative to surgical removal and may be used for small tumors.
  8. Electrodesiccation and curettage: This involves using a small electric current to destroy cancer cells, followed by scraping them out with a spoon-shaped tool called a curette. It may be used for small, superficial tumors.
  9. Laser surgery: Laser surgery involves using a high-energy beam of light to destroy cancer cells. It is a precise and minimally invasive alternative to surgical removal and may be used for small tumors.
  10. Topical chemotherapy: Topical chemotherapy involves applying drugs directly to the skin’s surface to kill cancer cells. It is typically used for early-stage PC and may cause fewer side effects than systemic chemotherapy.
  11. Photodynamic therapy: This involves applying a photosensitizing drug to the skin, followed by shining a special light on the area to activate the drug, which then kills cancer cells. It is a newer treatment option for PC that shows promise in early studies.
  12. Intralesional injection: This involves injecting a drug directly into the tumor to kill cancer cells. It may be used for small tumors or as an adjuvant therapy after surgery.
  13. Interferon therapy: Interferon therapy involves using drugs that mimic the body’s natural immune response to kill cancer cells. It may be used as an adjuvant therapy after surgery or in combination with other treatments for advanced PC.
  14. Cryotherapy: Cryotherapy involves freezing the tumor with liquid nitrogen to destroy cancer cells. It may be used as an adjuvant therapy after surgery or in combination with other treatments for advanced PC.
  15. Radiofrequency ablation: This involves using high-energy radio waves to destroy cancer cells. It may be used as an alternative to surgery for small tumors or as an adjuvant therapy after surgery.
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Drugs Treatment

Drugs that have been used in the treatment of pilomatrical carcinoma:

  1. Carboplatin: Carboplatin is a chemotherapy drug that is used to treat a variety of cancers. It works by damaging the DNA of cancer cells, which prevents them from dividing and growing. Carboplatin is often used in combination with other chemotherapy drugs to treat pilomatrical carcinoma.
  2. Cisplatin: Cisplatin is another chemotherapy drug that is commonly used to treat various types of cancers. Like carboplatin, it works by damaging the DNA of cancer cells. Cisplatin is often used in combination with other chemotherapy drugs to treat pilomatrical carcinoma.
  3. Doxorubicin: Doxorubicin is a chemotherapy drug that is commonly used to treat breast cancer, lymphoma, and other types of cancer. It works by interfering with the DNA of cancer cells, which prevents them from dividing and growing. Doxorubicin is sometimes used to treat pilomatrical carcinoma.
  4. Methotrexate: Methotrexate is a chemotherapy drug that is commonly used to treat various types of cancer. It works by inhibiting the growth of cancer cells. Methotrexate is sometimes used to treat pilomatrical carcinoma.
  5. 5-fluorouracil: 5-fluorouracil is a chemotherapy drug that is commonly used to treat skin cancer, as well as other types of cancer. It works by interfering with the DNA of cancer cells, which prevents them from dividing and growing. 5-fluorouracil is sometimes used to treat pilomatrical carcinoma.
  6. Imiquimod: Imiquimod is a topical medication that is commonly used to treat skin cancer, as well as genital warts. It works by stimulating the body’s immune system to attack cancer cells. Imiquimod is sometimes used to treat pilomatrical carcinoma.
  7. Interferon alpha: Interferon alpha is a medication that is commonly used to treat hepatitis B and C, as well as certain types of cancer. It works by stimulating the body’s immune system to attack cancer cells. Interferon alpha is sometimes used to treat pilomatrical carcinoma.
  8. Vincristine: Vincristine is a chemotherapy drug that is commonly used to treat various types of cancer, including lymphoma and leukemia. It works by interfering with the DNA of cancer cells, which prevents them from dividing and growing. Vincristine is sometimes used to treat pilomatrical carcinoma.
  9. Etoposide: Etoposide is a chemotherapy drug that is commonly used to treat various types of cancer, including lung cancer and leukemia. It works by interfering with the DNA of cancer cells, which prevents them from dividing and growing. Etoposide is sometimes used to treat pilomatrical carcinoma.
  10. Topotecan: Topotecan is a chemotherapy drug that is commonly used to treat ovarian cancer and small cell lung cancer. It works by interfering with the DNA of cancer cells, which prevents them from dividing and growing. Topotecan is sometimes used to treat pilomatrical carcinoma.
  11. Bleomycin: Bleomycin is a chemotherapy drug that is commonly used to treat various types of cancer, including testicular cancer and lymphoma. It works by interfering with the DNA of cancer cells, which prevents them from dividing and growing. Bleomycin is sometimes used to treat
References


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