Our Gynecologic Pathology cases @UMiamiPathology are fascinating! Here’s a striking example of pilomatrix-like high-grade endometrial carcinoma (PiMHEC), a recently described entity mostly driven by CTNNB1 mutations. Look for solid basaloid growth with conspicuous central tumor cell necrosis, and pilomatrix-like keratinization with the hallmark ghost cells. This case also had a focal conventional FIGO grade 1 endometrioid component. IHC shows diffuse nuclear β-catenin with loss of PAX8 and ER in the pilomatrix-like component. These tumors are believed to behave aggressively.