Pilomatrixoma Presenting as a Rapidly Expanding Mass of the Infant Nasion

Area of Science:

• Dermatology
• Pediatric Oncology
• Pathology

Background:

• Pilomatrixomas are benign neoplasms arising from hair follicle cells.
• Typically present as solitary masses on the head and neck, common in children but rare in infants.
• Atypical presentations can challenge preoperative diagnosis.

Purpose of the Study:

• To present a rare case of pilomatrixoma in an 11-month-old infant.
• To describe the management of an atypical pilomatrixoma on the midline nasion.
• To review the literature on pilomatrixomas, emphasizing unusual infantile cases.

Main Methods:

• Case presentation of an 11-month-old infant with an atypical nasion mass.
• Utilized computed tomography (CT) and magnetic resonance imaging (MRI) for preoperative assessment.
• Diagnosis confirmed by histopathological examination post-surgical excision.
• Conducted a comprehensive literature review on pilomatrixomas.

Main Results:

• The patient presented with an atypical pilomatrixoma not correlating with typical descriptions.
• Preoperative imaging (CT, MRI) did not lead to a definitive diagnosis.
• Histopathology confirmed pilomatrixoma after surgical excision.
• The patient showed no evidence of recurrence post-treatment.

Conclusions:

• This is the first reported case of a pilomatrixoma presenting on the midline nasion in an infant.
• Clinicians should consider pilomatrixoma in the differential diagnosis of pediatric head and neck skin lesions, even with atypical presentations.
• Complete surgical excision is the definitive and effective treatment for pilomatrixoma.