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Pilomatrixoma in a child mimicking a ruptured epidermal cyst clinically and histopathologically: Case report
Hind M Alkatan1, Wajda Alhothali2, Ola Alnuhayer3
1Department of Ophthalmology, College of Medicine, King Saud University, Riyadh, Saudi Arabia; Department of Pathology & Laboratory Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia; King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia.
Insights
Pilomatrixomas, benign skin tumors, are often misdiagnosed as epidermal inclusion cysts. Accurate diagnosis requires histopathological examination after surgical removal, especially in atypical presentations.
Area of Science:
- Dermatology
- Ophthalmology
- Pathology
Background:
- Pilomatrixoma is a common benign skin tumor originating from hair follicle matrix cells.
- It typically affects individuals in their first two decades, often on the head and neck, particularly the eyelids and eyebrows.
Purpose of the Study:
- To highlight an atypical presentation of pilomatrixoma mimicking a ruptured epidermal cyst.
- To emphasize the diagnostic challenges and the importance of histopathological confirmation.
Main Methods:
- Presentation of a case study involving a 14-year-old patient with a pilomatrixoma.
- Clinical and histopathological evaluation of the skin lesion.
Main Results:
- The pilomatrixoma presented atypically, resembling a ruptured epidermal cyst with recurrent inflammation and discharge.
- Preoperative diagnosis accuracy for pilomatrixomas ranges from 0% to 30%, with definitive diagnosis requiring histopathology.
Conclusions:
- Pilomatrixomas are frequently misdiagnosed preoperatively, often confused with other benign masses like dermoid or epidermal inclusion cysts.
- Ophthalmologists and ocular pathologists must recognize atypical pilomatrixoma presentations for timely and accurate diagnosis and treatment.
Introduction And Importance:
Pilomatrixoma is a superficial benign skin tumor that originates from the matrix cells of the hair follicles. It presents more frequently during the first two decades of life and usually involves the head and neck, most often in the eyelid or eyebrow area.
Case Presentation:
We present a case of pilomatrixoma, which appeared at the age of 14 years with history of recurrent inflammation and discharge mimicking a ruptured epidermal cyst.
Discussion:
Pilomatrixomas are often confused clinically with other benign masses, encountered in the clinical practice more frequently like dermoid cysts and epidermal inclusion cysts. The rate of accurate preoperative diagnosis ranges between 0%-30% and the correct diagnosis can be established only after excision and histopathological examination. Our case demonstrates an atypical presentation of pilomatrixoma as an epidermal inclusion cyst.
Conclusion:
Ophthalmologists and ocular pathologists should be aware of the atypical presentation of pilomatrixomas to ensure early accurate diagnosis and curative treatment.
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