[Pilomatrixoma often not identified as such]

To inventory incidence, diagnosis and treatment of pilomatrixoma.

Retrospective.

Patients treated in the period 1984-1996 in the department of Surgery of the Medical Spectrum Twente, Enschede for a pilomatrixoma were traced via the Dutch Automatic Morbid-Anatomical Records Office (PALGA). Data were collected by status study. Also, the patients or their parents were interviewed by telephone about recurrences.

Forty-eight patients with 54 pilomatrixomas had been treated. The ages varied from 2 to 77 years, 14 patients were younger than 14 years. The correct diagnosis had been made preoperatively in 11 patients (20%) in four of whom (7%) the manifestation was not the first one. In many cases (69%), the condition was mistaken for an atheromatous cyst, in children as well (in 47% of the cases). The pilomatrixoma was localized in the head and neck area 25 times, in eight of these in the parotid region. Owing to incorrect interpretation of the abnormality, three children with a pilomatrixoma in the head and neck area underwent a more radical operation than necessary.

The clinical diagnosis was frequently missed. In cutaneous tumours occurring in children or localized in the head and neck area the diagnosis of pilomatrixoma should be considered.