Pilomatrix Carcinoma: Report of Two Cases of the Head and Review of the Literature

Pilomatrix carcinoma (PC) is a rare and aggressive skin tumor originating from hair follicle matrix cells, predominantly affecting males in their sixth and seventh decades of life, with 62% of cases occurring on the head. This study presents two cases and reviews 52 tumors from the literature, highlighting the challenges in diagnosis and treatment due to its rarity and potential for metastasis, which occurs in 17% of cases. The preferred treatment is wide local excision, but there is a high recurrence rate of 21%, and metastases primarily affect the lungs and lymph nodes. Adjuvant therapies like radiotherapy and chemotherapy are sometimes necessary. The study emphasizes the importance of awareness, early detection, and complete surgical excision with clear margins to improve patient outcomes. Regular follow-up is crucial, although specific guidelines are lacking.