case_images: PMC11170102_01
case_images: Photograph of the patient showing a soft, solitary, subcutaneous, and slow-growing mass (about 5 cm) in the left inguinal region with a sutured wound for biopsy surgery.
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case_images: PMC11170102_01_fimmu-15-1337400-g001.jpg
case_images: f1
case_images: A 55-year-old man had a soft, isolated, subcutaneous, slow-growing mass (approximately 5 cm) in the left inguinal region ( Figure 1 ).
case_images: MRI and CT scan. (A) MRI scan of the abdominopelvic cavity showing irregular, slightly longer T1 and slightly longer T2 confounding signals in the iliosas muscle of the left iliac bone anterior edge. Its visible patchy short T2 signal, unclear boundary, and pressure lipid sequence was mixed with high signal, about 7.21 cm x 4.88 cm. The left iliac fossa and left inguinal area had scattered enlarged lymph nodes, with a larger diameter of about 1.6 cm. (B, C) MRI scan showing bone destructions in the left suprapuphysical branch and left acetabulum. (D) Chest CT showing multiple calcification foci and a few cables in the posterior segment of the upper lobe of the left lung and small nodules in the posterior segment of the right upper lung and the dorsal segment of the left lung. The larger diameter was about 3.4 mm; clear texture of the remaining lungs, no signs of stenosis and compression.
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case_images: PMC11170102_01_fimmu-15-1337400-g002.jpg
case_images: f2
case_images: The chest CT showed multiple calcification foci and a few cables in the posterior segment of the upper lobe of the left lung and small nodules in the posterior segment of the right upper lung and the dorsal segment of the left lung; the larger diameter was approximately 3.4 mm, and there was a clear texture in the remaining lungs, with no signs of stenosis or compression ( Figure 2 ). The patient subsequently underwent left pelvic lesion open biopsy and inguinal lymph node resection biopsy. The pathological examination revealed that the left inguinal mass was a malignant tumor of cutaneous accessory origin (pilomatrix carcinoma) with extensive vitreous changes. The suprapupubis branch mass was considered to be a bone metastatic pilomatrix carcinoma ( Figure 3 ).
case_images: Histopathology displaying low-power microscopic view of left inguinal mass consisting of cutaneous accessory origin (atypical basaloid cells with frequent mitoses) with extensive vitreous changes fitting the diagnosis of pilomatrix carcinoma, H&E staining x100 original magnification.
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case_images: PMC11170102_01_fimmu-15-1337400-g003.jpg
case_images: f3
case_images: The chest CT showed multiple calcification foci and a few cables in the posterior segment of the upper lobe of the left lung and small nodules in the posterior segment of the right upper lung and the dorsal segment of the left lung; the larger diameter was approximately 3.4 mm, and there was a clear texture in the remaining lungs, with no signs of stenosis or compression ( Figure 2 ). The patient subsequently underwent left pelvic lesion open biopsy and inguinal lymph node resection biopsy. The pathological examination revealed that the left inguinal mass was a malignant tumor of cutaneous accessory origin (pilomatrix carcinoma) with extensive vitreous changes. The suprapupubis branch mass was considered to be a bone metastatic pilomatrix carcinoma ( Figure 3 ).
case_images: Immunohistochemical detection of PDL1 showing the positive control slide (A) and patient's biopsy tissue (B) (PDL1 combined positive score (CPS): 8). Staining, x400 original magnification.
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case_images: PMC11170102_01_fimmu-15-1337400-g004.jpg
case_images: f4
case_images: Immunohistochemical detection revealed a PDL1 combined positive score (CPS) of 8 ( Figure 4 ).