# A Rare Case of Pilomatricoma of the Male Breast Mimicking Breast Carcinoma: A Diagnostic Challenge

## TL;DR

A rare case of a benign skin tumor in a man's breast was initially mistaken for cancer, highlighting the importance of biopsy for accurate diagnosis.

## Contribution

Reports a rare case of pilomatricoma in the male breast, emphasizing its diagnostic challenges and the need for histologic confirmation.

## Key findings

- The tumor showed classic pilomatricoma features including basaloid cells and shadow cells.
- Beta-catenin staining was strong and diffuse in the basaloid cells.
- The case underscores the importance of biopsy to avoid misdiagnosis in unusual breast masses.

## Abstract

Pilomatricoma 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 a breast lump. Recognising this uncommon presentation is essential to avoid misdiagnosis and ensure appropriate management.