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This report describes a rare pilomatricoma of the breast in a 65-year-old male presenting with a palpable breast lump. Initial clinical and radiological assessment suggested primary breast carcinoma. Histopathology confirmed benign pilomatricoma with basaloid matrical cells, shadow (ghost) cells, and foreign body giant cell reaction, with diffuse beta-catenin staining. The case emphasizes diagnostic pitfalls of uncommon breast masses and the need for biopsy-based histologic confirmation.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":40,"@type":76,"position":81},"https://docshare.wps.com/document/research-report/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/a-rare-case-of-pilomatricoma-of-the-male-breast-mimicking-breast-carcinoma-a-diagnostic-challenge/445266/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/a-rare-case-of-pilomatricoma-of-the-male-breast-mimicking-breast-carcinoma-a-diagnostic-challenge/445266.png","ImageObject",300,407,{"name":92,"@type":93},"dabgoudw","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-04","2026-09-29",true,{"@type":102,"interactionType":103,"userInteractionCount":81},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What makes pilomatricoma difficult to diagnose in the male breast?","Question",{"text":112,"@type":113},"It can mimic more common malignant breast lumps in both clinical presentation and imaging appearance, leading to suspicion for primary breast carcinoma.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"What did imaging suggest in this case?",{"text":117,"@type":113},"Mammography showed a well-circumscribed irregular dense mass without microcalcifications, and ultrasound demonstrated an irregular heterogeneously hypoechoic solid mass with posterior shadowing; the overall impression was suspicious for primary malignancy (BI-RADS 5).",{"name":119,"@type":110,"acceptedAnswer":120},"How was the diagnosis ultimately confirmed?",{"text":121,"@type":113},"Histopathological examination of the excised tissue showed benign pilomatricoma features, including basaloid matrical cells, shadow (ghost) cells, foreign body giant cell reaction, and strong diffuse beta-catenin staining; tissue confirmation was emphasized as necessary.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},445266,1790889498,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":39,"category_name":40,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":81,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":29,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":144},3985747860484,"https://ap-avatar.wpscdn.com/davatar_276721f389ce27ea32af1340a28f341c","Review began 10/24/2025  \nReview ended 12/03/2025  \nPublished 12/07/2025  \n© Copyright 2025  \nTay et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 4.0. , which permits unrestricted use , distribution , and reproduction in any medium , provided the original author and source are credited.  \nDOI: 10.7759/cureus.98654  \nOpen Access Case Report  \nA Rare Case of Pilomatricoma of the Male Breast Mimicking Breast Carcinoma: A Diagnostic Challenge  \nElena Wen Xuan Tay 1 , Naman Siddique 2, Olga Shmuilovich 3 , Anat Kornecki 3 , Mariamma G. Joseph 4  \n1. Department of Health Sciences, Western University, London, CAN 2. Department of Medical Imaging, London Health Sciences Centre/Western University, London, CAN 3. Department of Medical Imaging, St. Joseph 's Health  \nCentre/Western University, London, CAN 4. Department of Pathology and Laboratory Medicine, London Health Sciences Centre/Western University, London, CAN  \nCorresponding author: Mariamma G. Joseph, [mariamma.joseph@lhsc.on.ca](mariamma.joseph@lhsc.on.ca)  \nAbstract  \nPilomatricoma is a benign skin adnexal tumour often seen in children and young adults. We report a rare case of pilomatricoma of the breast in a 65-year-old male patient who presented with a palpable breast lump. Initial clinical and radiological evaluation suggested primary breast carcinoma. Histopathological examination showed classic features of a benign pilomatricoma with basaloid matrical cells, shadow (ghost) cells, and a foreign body giant cell reaction. There was only minimal microcalcification present. There was strong and diffuse nuclear and cytoplasmic staining of basaloid matrical cells for beta-catenin. This case highlights the diagnostic challenges posed by uncommon breast masses and emphasises the need for histologic confirmation by a tissue biopsy. Pathologists and clinicians should be aware that although pilomatricoma is a common skin adnexal tumour in the head and neck region, it can rarely present as abreast lump. Recognising this uncommon presentation is essential to avoid misdiagnosis and ensure appropriate management.  \nCategories: Radiology, Pathology  \nKeywords: benign skin adnexal tumors, beta-catenin ctnnb1, diagnostic challenges, male breast tumor, pathology, pilomatricoma, radiology  \nIntroduction  \nPilomatricoma (PLM), also previously known as calcifying epithelioma of Malherbe, is a benign, slowly growing skin adnexal tumour showing hair follicle differentiation towards the matrical portion of the hair bulb and hair cortex [1] . It occurs commonly in children and young adults as a solitary papule or nodule, mostly in the head and neck region (50%), followed by extremities (upper 25%, lower 10%) and trunk (15%) [1] . This neoplasm usually presents as a firm and painless dermal or subcutaneous mass. PLM of the breast is exceptionally rare, and the diagnostic challenge with this tumour lies in its ability to mimic more common aggressive malignant breast lumps, both in clinical presentation and imaging findings [2] . Here, we describe the clinicopathological and imaging findings of PLM of the breast in a male patient and highlight the importance of including this tumour in the differential diagnoses of patients presenting with breast  \nlumps.  \nCase Presentation  \nA 65-year-old man presented with a slightly painful palpable lump on his left breast. He first noticed the lesion six months ago and has observed only slow growth since then. On physical examination, he had amultinodular firm mass measuring 2-3 cm in diameter, located on the upper outer quadrant of the left breast. The mass was slightly tender on palpation and firm but not fixed to the underlying fascia. There was slight erythema and stretching of the overlying skin, but no ulceration. There was no associated cervical, supraclavicular, infraclavicular or axillary lymphadenopathy. The patient was evaluated at the Breast Imaging Centre, and a clinical/imaging sus","cbCaiv8oLNPru7j4","https://ap.wps.com/l/cbCaiv8oLNPru7j4","pdf",5298452,"English","# Introduction\n# Case Presentation\n## Radiology findings\n## Pathology findings","[{\"question\":\"What makes pilomatricoma difficult to diagnose in the male breast?\",\"answer\":\"It can mimic more common malignant breast lumps in both clinical presentation and imaging appearance, leading to suspicion for primary breast carcinoma.\"},{\"question\":\"What did imaging suggest in this case?\",\"answer\":\"Mammography showed a well-circumscribed irregular dense mass without microcalcifications, and ultrasound demonstrated an irregular heterogeneously hypoechoic solid mass with posterior shadowing; the overall impression was suspicious for primary malignancy (BI-RADS 5).\"},{\"question\":\"How was the diagnosis ultimately confirmed?\",\"answer\":\"Histopathological examination of the excised tissue showed benign pilomatricoma features, including basaloid matrical cells, shadow (ghost) cells, foreign body giant cell reaction, and strong diffuse beta-catenin staining; tissue confirmation was emphasized as necessary.\"}]","A Rare Case of Pilomatricoma of the Male Breast Mimicking Breast Carcinoma - A Diagnostic Challenge | PDF",1790711028,15]