Question:

Which of the following answer choices is false?
1. Pilomatrixomas can not usually be clinically evaluated.
2. Clinical examination is not sufficient in diagnosing pilomatrixomas.
3. Surgical excision of pilomatrixomas is advisable.
4. Core-needle biopsy is superior to fine needle aspiration cytology in the diagnosis of pilomatrixomas.
5. Pilomatrixomas should be considered in the differential diagnosis of breast nodules showing microcalcifications.





Answer:

The correct answer for the question "Which of the following answer choices is false?" is:

1. Pilomatrixomas can not usually be clinically evaluated.



Explanation
1. Pilomatrixomas are usually lesions causing skin alterations. [On physical examination these lesions appear as hard nodules with lobulated margins. In addition there may be other signs such rubor, calor, dolor for inflammatory phenomena. The skin can be intact, purple or rarely ulcerated].

2. Pilomatrixomas simulate breast cancer and need to be investigated with mammography, ultrasound and core-needle biopsy for a definitive diagnosis. [While lesions in the skin are often easily diagnosed, breast pilomatrixomas require several diagnostic tests due to the difficulty of distinguishing these lesions from breast cancer].

3. Despite the lack of articles regarding malignant pilomatrixomas of the breast, , we suggest to perform a surgical biopsy to obtain a definitive histological diagnosis. [In conclusion, pilomatrixomas, despite their rarity, should be considered in the differential diagnosis of calcified nodules visible on mammograms and, although there are not cases of malignant intramammary pilomatrixomas, an excisional biopsy for a definitive diagnosis might be advisable].

4. Core-needle biopsy is considered a safe technique for diagnosing breast nodules. [On the other hand, core-needle biopsy has proved to be an effective and safe technique for diagnosing breast nodules and should be performed to obtain a pre-surgical diagnosis].

5. Pilomatrixomas usually show calcifications and can simulate calcifying breast nodules. [In conclusion, pilomatrixomas, despite their rarity, should be considered in the differential diagnosis of calcified nodules visible on mammograms].



From the manuscript:
Pilomatrixoma of the breast, a rare lesion simulating breast cancer: a case report
Radiology Case. 2013 Oct; 7(10):43-50


This article belongs to the Mamms section.




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From the manuscript

Pilomatrixoma of the breast, a rare lesion simulating breast cancer: a case report

Free full text article: Pilomatrixoma of the breast, a rare lesion simulating breast cancer: a case report

Abstract
Pilomatrixoma or calcifying epithelioma of Malherbe is a rare, benign, skin tumour originating from piliferous follicles; breast localization is considered to be very rare. These lesions can origin from the peri-areolar piliferous bulbs and, due to the clinical and imaging features, be easily misdiagnosed as a breast neoplasm. We present a case of pilomatrixoma of the left breast in a woman of 43 years appearing as a firm, deep nodule in the external quadrants. The lesion had mammographic and sonographic malignant features, but histological analysis on core-needle biopsy and surgical specimens revealed this unusual benign lesion.






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