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[Pilomatrixoma - an important differential diagnosis of facial masses]
S K Graß1, C M C Deichmüller1, A Brandis2
1Klinik für HNO-Heilkunde, regionale plastische Chirurgie, Kopf- und Halschirurgie, Klinikum Nordstadt, Hannover.
Insights
Pilomatrixoma, common in children
Area of Science:
- Oncology
- Pediatric Oncology
- Dermatopathology
Background:
- Pilomatrixoma are rare subcutaneous tumors, frequently affecting the cheek and parotid region in children.
- These tumors represent approximately 20% of pediatric head and neck masses.
- Limited literature exists on the characteristic findings of pilomatrixoma.
Purpose of the Study:
- To detail the clinical, sonographical, and morphological features of pilomatrixoma.
- To enhance understanding of these rare pediatric tumors.
Main Methods:
- Retrospective analysis of clinical records from 6 surgically treated pilomatrixoma patients.
- Complete tumor excision followed by histopathological examination (H&E staining).
Main Results:
- Patients presented with slow-growing, painless parotid or nuchal masses.
- Sonography revealed hyperechoic masses with dorsal sound attenuation due to calcification.
- Histopathology showed characteristic basaloid and ghost cells with a foreign-body reaction.
Conclusions:
- Pilomatrixoma is a key differential diagnosis for pediatric head and neck masses.
- Sonographic findings are variable and non-specific; fine-needle aspiration biopsy is discouraged due to potential false malignant results.
- Complete surgical excision is the recommended treatment, typically with a good prognosis and no need for adjuvant therapy.
Background:
Pilomatrixoma are rare tumors usually arising from the sebaceous glands in the subcutaneous tissue. They are the most frequent superficially localized tumors of the cheek and parotid region in children. About 20% of all tumors in this area in children are pilomatrixoma. Currently there are only a few studies in the literature which describe characteristic findings in these tumors. The purpose of the present study was to describe clinical, sonographical and morphological characteristics of these rare tumors.
Patients And Methods:
Clinical records of 6 patients which were operated on for a pilomatrixoma were retrospectively analyzed. All tumors were completely excised followed by an histopathological examination on H&E stained specimens.
Results:
All patients reported about a slowly growing painless mass in the parotid area or nuchal. Sonographically tumors displayed as hyperechoic masses with a dorsal sound extinction, due to hypercalcification. Histopathologically all tumors were characterized by typical basaloid and ghost cells, accompanied by a foreign-body reaction.
Conclusion:
Pilomatrixoma are an important differential diagnosis of unclear masses in the head and neck especially in children. The sonographical characteristics are variable and unspecific. A fine-needle aspiration biopsy is not recommended, since false malignant cytologic findings occur quite often. Therapeutically complete excision is required. Usually no adjuvant therapy is necessary, and the prognosis is good.
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