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Pilomatrixoma and its Imitators.

Adelaide Zhao1, Suraj Kedarisetty1, Aileen Grace P Arriola2

  • 1Departments of Otolaryngology--Head & Neck Surgery, Lewis Katz School of Medicine at Temple University, Philadelphia, PA, USA.

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|September 22, 2021
PubMed
Summary
This summary is machine-generated.

Pilomatrixomas are common pediatric head and neck tumors. Surgical excision without imaging is often accurate, though other lesions may mimic these benign neoplasms.

Keywords:
childfollicular cystgiant molluscum lesionpilomatrixomaskin tumor

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Area of Science:

  • Pediatric Otolaryngology
  • Dermatopathology
  • Surgical Oncology

Background:

  • Pilomatrixomas are common benign neoplasms of hair follicle matrix cells, frequently presenting as pediatric head and neck tumors.
  • Characteristically, they appear as firm, slow-growing, subcutaneous masses adherent to the epidermis.

Approach:

  • A 20-year retrospective review of pediatric otolaryngology cases identified patients with suspected pilomatrixomas.
  • The study evaluated the efficacy of physical examination in differentiating pilomatrixomas from other soft tissue lesions.

Key Points:

  • Of 18 patients with clinically suspected pilomatrixomas, 15 were confirmed histologically.
  • Three cases were misdiagnosed preoperatively, including an epidermal inclusion cyst, a ruptured trichilemmal cyst, and molluscum contagiosum.
  • Surgical excision is the primary treatment, with pathology confirming the diagnosis.

Conclusions:

  • Physical examination alone is highly suggestive of pilomatrixoma in pediatric head and neck masses.
  • While imaging like ultrasonography can aid diagnosis, surgical excision remains definitive for both pilomatrixomas and mimicking cystic lesions.