PMC9484469_01
A - Clinical aspect of the lesion. Details for regions of discoloration (ischemia) of the skin when the lesion is delimited and compressed against the buccal mucosa; B - contrasted CT examination showing the presence of a nodule with lobulated contours and tiny calcifications of subcutaneous permeation, reaching a dimension of 2.6 cm; C - dissection was performed using delicate Kelly forceps to separate the lesion capsule from adjacent muscle tissues and skin for total lesion excision in a single fragment; D - Macroscopic aspect of the lesion. A solid, well-defined lesion measuring approximately 24 mm x 14 mm x 12 mm.
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The lesion was superficial and the overlying skin became ischemic when finger-pressed (Figure 1A). CT showed a mixed image with the presence of hyperdense dots attached to the adjacent skin (Figure 1B). Clinical and imaging data determined the diagnostic hypothesis of a dermoid or epidermoid cyst. The lesion had dimensions of approximately 24 mm x 14 mm x 12 mm (Figure1C and 1D).
Photomicrograph of the tumor showing the presence of multiple cells without a nucleus (ghost cells) (H&E, 400x).
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Histological sections revealed a fragment of cutaneous neoplasia characterized by nests of epithelium with basaloid cells that underwent an abrupt transition to a completely keratinized epithelium, rich in ghost cells, with confirmation of pilomatrixoma (Figure 2).