title: Pilomatrix Carcinoma of the scalp. A case report and review of the literature.
abstract: BACKGROUND
  Pilomatrix Carcinoma (PC) is a rare and malignant dermo-hypodermic tumor. Only 11 cases were reported in patients younger than 18 years old and only 13 cases were reported on the scalp.
  
  
  METHODS
  We report the case of a 15-year-old woman who underwent cyst excision on the vertex. Anatomopathology shed light trichilemmal cyst. Five months later, she presented a first local recurrence. The tumor was removed with wide margin. Anatomopathology shed light PC. No adjuvant therapy was performed. The patient presented a second recurrence 3 months later with a parietal bone and superior sagittal sinus invasion and a lung metastasis. She underwent a craniotomy and radiochemotherapy. A third local recurrence was detected 4 months later. Three more lines of chemotherapy were performed without success.
  
  
  CONCLUSIONS
  PC is a locally aggressive tumour, with a high rate of local recurrences and metastases. PC arises de novo or through malignant transformation of a pilomatrixoma. PC were observed frequently in the white male over 50 years old. The histological diagnosis is difficult to prove. Treatment consists of a wide surgical excision. Peritumoral margins are not codified. Because of most cases are on the face and neck, Mohs Micrographic Surgery seems to be a good modality to limit margins. Radiation therapy is an adjuvant treatment. Chemotherapy can be used in metastasis case.
  
  
  CONCLUSIONS
  PC is a rare malignant tumor with high rate of disease relapse. Histological diagnosis is difficult and treatment is not standardized. Surgical procedure with wide margins is recommended to avoid the large recurrence when the staging shows no metastasis.
authors.affiliation: Service de chirurgie plastique et maxillo-faciale, hôpital Central, CHU de Nancy, 29, avenue du Maréchal-de-Lattre-de-Tassigny, 54000 Nancy, France. Electronic address: sorinthomas5154@gmail.com.
authors.forename: T
authors.initials: T
authors.lastname: Sorin
authors.affiliation: Service de chirurgie plastique et maxillo-faciale, hôpital Central, CHU de Nancy, 29, avenue du Maréchal-de-Lattre-de-Tassigny, 54000 Nancy, France.
authors.forename: H
authors.initials: H
authors.lastname: Eluecque
authors.affiliation: Service de chirurgie plastique et maxillo-faciale, hôpital Central, CHU de Nancy, 29, avenue du Maréchal-de-Lattre-de-Tassigny, 54000 Nancy, France.
authors.forename: G
authors.initials: G
authors.lastname: Gauchotte
authors.affiliation: Service de chirurgie plastique et maxillo-faciale, hôpital Central, CHU de Nancy, 29, avenue du Maréchal-de-Lattre-de-Tassigny, 54000 Nancy, France.
authors.forename: A
authors.initials: A
authors.lastname: De Runz
authors.affiliation: Service de chirurgie plastique et maxillo-faciale, hôpital Central, CHU de Nancy, 29, avenue du Maréchal-de-Lattre-de-Tassigny, 54000 Nancy, France.
authors.forename: J F
authors.initials: JF
authors.lastname: Chassagne
authors.affiliation: Service de chirurgie plastique et maxillo-faciale, hôpital Central, CHU de Nancy, 29, avenue du Maréchal-de-Lattre-de-Tassigny, 54000 Nancy, France.
authors.forename: L
authors.initials: L
authors.lastname: Mansuy
authors.affiliation: Service de chirurgie plastique et maxillo-faciale, hôpital Central, CHU de Nancy, 29, avenue du Maréchal-de-Lattre-de-Tassigny, 54000 Nancy, France.
authors.forename: H
authors.initials: H
authors.lastname: Gisquet
authors.affiliation: Service de chirurgie plastique et maxillo-faciale, hôpital Central, CHU de Nancy, 29, avenue du Maréchal-de-Lattre-de-Tassigny, 54000 Nancy, France.
authors.forename: E
authors.initials: E
authors.lastname: Simon
mesh_terms: D000293:Adolescent; D005260:Female; D006801:Humans; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local; D018296:Pilomatrixoma / Q000473:pathology* / Q000628:therapy; D012535:Scalp / Q000473:pathology* / Q000601:surgery; D012878:Skin Neoplasms / Q000473:pathology* / Q000628:therapy
keywords: Carcinoma; Carcinome; Chemotherapy; Chimiothérapie; Chirurgie; Pilomatrixoma; Pilomatrixome; Radiotherapy; Radiothérapie; Scalp; Surgery