[Pilomatricoma behind and below the ear: one case report]

Area of Science:

• Pediatric Dermatology
• Surgical Pathology
• Diagnostic Imaging

Background:

• Pilomatricoma is a benign calcifying epithelial tumor of the hair follicle, most common in children.
• A growing goiter-like mass behind the ear is an unusual presentation for pilomatricoma.
• Accurate diagnosis is crucial to differentiate from other pediatric neck masses.

Purpose of the Study:

• To report a rare case of pediatric pilomatricoma presenting as a growing neck mass.
• To describe the clinical and ultrasound features of this specific pilomatricoma presentation.
• To highlight the importance of histopathological confirmation.

Main Methods:

• Clinical examination of a 6-year-old boy with a 4-year history of a growing neck mass.
• B-mode ultrasound imaging to characterize the subcutaneous mass.
• Surgical excision and histopathological examination for definitive diagnosis.

Main Results:

• A 2.0 cm x 1.5 cm non-tender, protruding mass was noted behind the right ear.
• Ultrasound showed a 2.0 cm x 0.8 cm hyperechoic subcutaneous mass with unclear borders and no vascularity.
• Pathology confirmed the diagnosis of pilomatricoma.

Conclusions:

• Pilomatricoma can present atypically as a growing neck mass in children.
• Ultrasound is a useful tool in evaluating such masses, showing characteristic hyperechogenicity.
• Histopathology remains the gold standard for diagnosing pilomatricoma.