{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T05:18:12Z","timestamp":1793078292188,"version":"4.5.0"},"reference-count":16,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,2,3]],"date-time":"2026-02-03T00:00:00Z","timestamp":1770076800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Victor Babes University of Medicine and Pharmacy Timisoara"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:p>Pilomatrixoma is a benign skin adnexal tumor arising from the hair-follicle matrix. While typically small and slowly growing, rare \u201cgiant\u201d variants (&amp;gt;5\u202fcm)\u2014especially in the cervical region\u2014may clinically and radiologically mimic malignant masses, posing a significant diagnostic challenge. We report a case of a 29-year-old male presenting with a solitary, firm, subcutaneous mass (~6\u202fcm) in the left anterior cervical region, which enlarged rapidly over 6\u202fmonths without pain or systemic symptoms. Contrast-enhanced CT revealed a well-defined, heterogeneous subcutaneous lesion without muscular or vascular invasion. Core needle biopsy (CNB) supported a diagnosis of pilomatrixoma. The mass was completely excised under IV sedation and local anesthesia. Histopathology confirmed classic pilomatrixoma features (basaloid cells, shadow cells, foreign-body giant cell reaction). At one-year follow-up the patient was disease-free, and scar outcome was excellent. This case underscores the importance of including giant pilomatrixoma in the differential diagnosis of large cervical soft-tissue masses. Histopathological examination remains essential for definitive diagnosis, while CNB can guide preoperative planning. Complete surgical excision yields excellent outcomes with minimal morbidity, avoiding overtreatment for suspected malignancy.<\/jats:p>","DOI":"10.3389\/fmed.2026.1758413","type":"journal-article","created":{"date-parts":[[2026,2,3]],"date-time":"2026-02-03T05:22:32Z","timestamp":1770096152000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Diagnostic challenges of giant cervical pilomatrixoma mimicking malignancy: case report and focused literature review"],"prefix":"10.3389","volume":"13","author":[{"given":"Horatiu","family":"Urechescu","sequence":"first","affiliation":[{"name":"Department of Oral and Maxillo-Facial Surgery, Victor Babes University of Medicine and Pharmacy","place":["Timisoara, Romania"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marius","family":"Pricop","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillo-Facial Surgery, Victor Babes University of Medicine and Pharmacy","place":["Timisoara, Romania"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Flavia","family":"Zara","sequence":"additional","affiliation":[{"name":"Department of Microscopic Morphology, Victor Babes University of Medicine and Pharmacy","place":["Timisoara, Romania"]},{"name":"Angiogenesis Research Center, Victor Babes University of Medicine and Pharmacy","place":["Timisoara, Romania"]},{"name":"Service of Pathology, Emergency City Hospital","place":["Timisoara, Romania"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raluca Maria","family":"Closca","sequence":"additional","affiliation":[{"name":"Department of Microscopic Morphology, Victor Babes University of Medicine and Pharmacy","place":["Timisoara, Romania"]},{"name":"Angiogenesis Research Center, Victor Babes University of Medicine and Pharmacy","place":["Timisoara, Romania"]},{"name":"Service of Pathology, Emergency City Hospital","place":["Timisoara, Romania"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felicia","family":"Streian","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillo-Facial Surgery, Victor Babes University of Medicine and Pharmacy","place":["Timisoara, Romania"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,2,3]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"315","DOI":"10.1007\/s00383-025-06214-4","article-title":"Clinical features and surgical management of pilomatrixoma in children: a 332-case retrospective study","volume":"41","author":"Wang","year":"2025","journal-title":"Pediatr Surg Int"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"e172836","DOI":"10.1172\/JCI172836","article-title":"Infantile hemangioma: the common and enigmatic vascular tumor","volume":"134","author":"Holm","year":"2024","journal-title":"J Clin 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Dermatol"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"90","DOI":"10.5348\/101505Z01AS2025CR","article-title":"Rapidly growing giant pilomatrixoma in 57-year-old Hispanic male","volume":"16","author":"Sahrawat","year":"2025","journal-title":"Int J Case Rep Images"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"e409","DOI":"10.1097\/SCS.0000000000009092","article-title":"Giant Pilomatricoma mistaken for a malignant tumor","volume":"34","author":"Choi","year":"2023","journal-title":"J Craniofac Surg"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"183","DOI":"10.1177\/01455613211044778","article-title":"Pilomatrixoma and its imitators","volume":"103","author":"Zhao","year":"2021","journal-title":"Ear Nose Throat J"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"156","DOI":"10.1159\/000539123","article-title":"Pilomatrix carcinoma: a benign-mimic with malignant consequences\u2013a case report and review of the current 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Surg"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"1855","DOI":"10.1016\/j.jpedsurg.2011.05.009","article-title":"Giant pilomatrixoma mimicking a malignant parotid mass","volume":"46","author":"Cozzi","year":"2011","journal-title":"J Pediatr Surg"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"4759018","DOI":"10.1155\/2014\/4759018","article-title":"Complicated giant pilomatrixoma of the parotid region","volume":"2014","author":"Ayd\u0131n","year":"2014","journal-title":"Case Rep Otolaryngol"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"288","DOI":"10.7181\/acfs.2020.00208","article-title":"Rapidly growing giant pilomatricoma in the right parotid","volume":"21","author":"Koh","year":"2020","journal-title":"Arch Craniofac Surg"},{"key":"ref16","first-page":"147","article-title":"Giant pilomatrixoma arising in the preauricular region: a case report","volume":"12","author":"Yuca","year":"2004","journal-title":"Kulak Burun Bogaz Ihtis Derg"}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1758413\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,3]],"date-time":"2026-02-03T05:22:33Z","timestamp":1770096153000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1758413\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,3]]},"references-count":16,"alternative-id":["10.3389\/fmed.2026.1758413"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2026.1758413","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,3]]},"article-number":"1758413"}}