Article Text
Summary
Endometrioid carcinoma with a prominent squamous component has the ability to mimic pilomatrixoma. One previous case is documented of cutaneous metastasis in the upper limb derived from ovarian endometrioid carcinoma mimicking pilomatrixoma. Here, we describe a case of metastasis of endometrial endometrioid carcinoma in the distal vagina, treated with radiotherapy and later resected. The histology of the lesion was thought initially to represent pilomatrixoma; this has not previously been described in the vagina, where no hair matrix cells are normally present. We hypothesise that radiotherapy may have effectively ‘sterilised’ the glandular component, blinding the malignant features. Further management was significantly altered by the reinterpretation of this result as metastatic disease. We emphasise that in the context of known endometrioid carcinoma, the diagnosis of pilomatrixoma should be made with caution, particularly where radiotherapy has been used.
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Footnotes
Contributors SMS drafted the manuscript and collated contributions from other authors. PB made the pathological diagnosis, and provided comments and images related to histology. CJ was the radiation oncologist involved in the case and provided discussion, input and patient communication (including written consent). OM was the gynaecology oncologist involved in the case, performed the surgery (with images included in the report) and provided input and comments around the case.
Competing interests None declared.
Patient consent Obtained.
Provenance and peer review Not commissioned; externally peer reviewed.