Matrical carcinoma with melanocytic hyperplasia (MCMH), previously referred to as malignant melanocytic matricoma, is a rare variant of the uncommon pilomatrical carcinoma, which occurs most often on the head/neck and upper backs of middle‐aged men. Nodular lesions may resemble pigmented basal cell carcinoma or melanoma clinically. We present a case of MCMH in a Hispanic patient with history of melanoma. Histopathologic clues to appropriate diagnosis include basaloid cells, numerous atypical mitoses, matrical differentiation, shadow cells, strong diffuse nuclear and cytoplasmic expression of beta catenin, and interspersed pigmented dendritic melanocytes.
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