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Pilomatricoma: experience of the hospital for sick children
Tatiana Karine Simon Cypel1, Vijith Vijayasekaran, Gino R Somers
1The Hospital for Sick Children, Toronto, Ontario.
Insights
Pilomatricoma, a common pediatric skin neoplasm, is often misdiagnosed. This study reviewed 93 cases, finding surgical excision effective with no recurrences, highlighting its importance in differential diagnosis.
Area of Science:
- Pediatric Dermatology
- Dermatopathology
- Surgical Oncology
Background:
- Pilomatricoma, also known as calcifying epithelioma of Malherbe, is a frequent skin neoplasm in children.
- It is often misdiagnosed as other pediatric skin conditions or tumors, complicating diagnosis and treatment.
Purpose of the Study:
- To retrospectively review the clinical and histopathological presentation of pilomatricoma in a pediatric population.
- To analyze patient demographics, tumor characteristics, and treatment outcomes.
Main Methods:
- A retrospective search of the pathology department records at The Hospital for Sick Children, Toronto, for pilomatricoma cases between 2001 and 2006.
- Review of patient records to determine sex, age, tumor location, size, pathological features, and recurrence rate.
- All identified lesions were treated with surgical excision.
Main Results:
- 93 pilomatricoma lesions in 85 pediatric patients were identified, with a median age of 8.7 years; 52% were female.
- Common sites included the face (48%), neck (21%), and upper limbs (18%). Lesions presented as asymptomatic, slow-growing, superficial, hard masses with bluish discoloration.
- Histopathological examination confirmed the diagnosis in all cases, with ghost cells and basaloid cells present in 83%. No recurrences were observed.
Conclusions:
- Pilomatricoma should be considered in the differential diagnosis of solitary firm skin nodules in children, particularly on the face, neck, and upper limbs.
- Clinical examination can often aid in diagnosis.
- Surgical excision is the recommended treatment with a very low recurrence rate.
Background:
Pilomatricoma (calcifying epithelioma of Malherbe) is a common skin neoplasm in the pediatric population that is often misdiagnosed as other skin conditions or tumours.
Objectives:
The objective of the present retrospective study was to review the clinical and histopathological presentation of this neoplasm in children.
Methods:
The records of the pathology department at The Hospital for Sick Children, Toronto, Ontario, were searched for all cases of pilomatricoma between 2001 and 2006. The records of these patients were reviewed to determine sex, age, location and size of the tumour, pathological features and recurrence rate. All patients underwent surgical excision of the lesions.
Results:
A total of 93 lesions in 85 patients were identified. The median age was 8.7 years. Of the 85 patients diagnosed with pilomatricoma, 44 (52%) were female. In all cases, the initial presentation was an asymptomatic, slow growing, superficial hard mass with bluish discolouration. The most common sites of occurrence were the face (48%), neck (21%) and upper limbs (18%). The size of the surgical specimens collected ranged from 0.1 cm to 2.6 cm. The diagnosis was confirmed by histopathological examination in all cases. Ghost cells and basaloid cells were described in most of the cases (83%). There were no recurrences in this series.
Conclusions:
This entity should be considered with other benign or malignant conditions in the clinical differential diagnosis of solitary firm skin nodules, especially those on the face, neck and upper limbs. The diagnosis can generally be made by clinical examination. The treatment of choice is surgical excision, and the recurrence rate is very low.
