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Head and neck pilomatrixoma in children
A Danielson-Cohen1, S J Lin, C A Hughes
1Department of Otolaryngology--Head and Neck Surgery, University of Illinois Hospital at Chicago, USA.
Insights
Pilomatrixoma, a common pediatric skin tumor, often affects girls and is typically diagnosed late. Increased clinical awareness can improve early pilomatrixoma diagnosis and reduce recurrence after surgical excision.
Area of Science:
- Pediatric Dermatology
- Surgical Oncology
- Oncology
Background:
- Pilomatrixoma is a benign skin neoplasm originating from hair follicle matrix cells.
- Head and neck pilomatrixomas are common in children, presenting diagnostic challenges.
Purpose of the Study:
- To review the etiology, clinical presentation, management, and outcomes of pediatric head and neck pilomatrixomas.
- To identify factors influencing diagnosis and recurrence rates.
Main Methods:
- Retrospective review of 51 pediatric patients with head and neck pilomatrixomas.
- Analysis of 55 tumors treated between January 1997 and March 1999.
- Evaluation of patient demographics, tumor characteristics, and treatment outcomes.
Main Results:
- The condition predominantly affected girls (71%) with an average age of 5.7 years.
- Cheek and periorbital areas were most common sites; 49% lacked correct preoperative diagnosis.
- Recurrence occurred in only 4% of cases after complete surgical excision.
Conclusions:
- Increased clinical awareness of pilomatrixoma can enhance preoperative diagnostic accuracy in children.
- Clinical findings are crucial for accurate diagnosis of this common benign skin tumor.
- Complete local excision is associated with a low rate of pilomatrixoma recurrence.
Objective:
To provide a review of the current information on the etiology, clinical presentation, management, and outcome of pilomatrixoma of the head and neck in children.
Design:
Retrospective review.
Setting:
A tertiary care pediatric center.
Patients:
Fifty-one pediatric patients with a diagnosis of pilomatrixoma of the head and neck.
Intervention:
All patients underwent excision of pilomatrixoma from January 1997 to March 1999. A total of 55 tumors were studied.
Results:
A preponderance of girls (n = 36; 71%) presented with this condition. The average age at diagnosis was 5.7 years, and the average size of the lesion was 1 cm. The skin of the cheek and the periorbital area were the most commonly involved sites. Only 27 lesions (49%) had a correct preoperative diagnosis. Two (4%) of 55 tumors recurred after complete surgical excision.
Main Outcome Measures:
The age and sex of the patient, preoperative diagnosis, time elapsed before diagnosis, site and size of the tumor, length of follow-up, presence of multiple or previous pilomatrixomas, and recurrence.
Conclusions:
Preoperative diagnosis may be improved with increased awareness of pilomatrixoma, a common, benign skin tumor in children. Clinical findings will aid in an accurate diagnosis. Recurrence after complete local excision is rare.