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Clinical and Pathological Features of Pilomatrixoma in Children: A Retrospective Study
Hongyang Fu1, Changbing Shen2,3, Bo Wu1
1Department of Dermatology, Shenzhen Baoan Women's and Children's Hospital, Jinan University, Shenzhen, China.
Insights
Pilomatrixoma in children often presents with two age peaks and is commonly found on the head and neck. Diagnosis accuracy remains low, highlighting the need for increased awareness of this benign skin neoplasm.
Area of Science:
- Pediatric Dermatology
- Oncology
- Pathology
Background:
- Pilomatrixoma is a common, benign skin neoplasm in children, frequently misdiagnosed.
- Understanding its clinical and pathological characteristics is crucial for accurate diagnosis and management.
Purpose of the Study:
- To summarize the clinical and pathological features of pilomatrixoma in pediatric patients.
- To analyze diagnostic accuracy and identify common presentation patterns.
Main Methods:
- Retrospective analysis of demographic, clinical, and pathological data from 171 pediatric pilomatrixoma patients.
- Evaluation of diagnostic rates (clinical and ultrasonic) and correlation of various features.
Main Results:
- Pilomatrixoma shows bimodal age distribution (≤1 year and 5-11 years) and predominantly affects the head and neck (77.2%).
- Correct diagnosis rates were low (clinical 50.9%, ultrasonic 38.6%). Shadow cells (99.4%) and basaloid cells (94.7%) were key pathological findings.
- Tumor volume positively correlated with disease duration, especially in upper limb cases.
Conclusions:
- Pilomatrixoma in children exhibits distinct age peaks and a predilection for the head and neck.
- Low diagnostic accuracy necessitates improved clinical recognition and diagnostic strategies.
- Pathological features like shadow cells are highly characteristic, aiding definitive diagnosis.
Introduction:
Pilomatrixoma is a benign skin neoplasm that is common in children and is often misdiagnosed. This study aimed to summarize the clinical and pathological features of pilomatrixoma in children.
Methods:
Data on demographic information, clinical and pathological features, diagnosis, and treatment of 171 patients with pilomatrixoma from Shenzhen Baoan Women's and Children's Hospital were collected and analyzed retrospectively.
Results:
The mean age of the patients was 5.7 (standard deviation [SD] = 3.9) years old, and there were 2 age peaks (≤1 year old, 5-11 years old) and 2 age valleys (2-4 years old, ≥12 years old). The mean disease course was 9.3 (SD = 14.1) months, 69.0%, 86.5%, and 95.3% of the patients' disease course in 6 months, 12 months, and 24 months, respectively. The mean tumor volume was 0.6 (SD = 1.0) cm3, and 81.3% of the patients' tumor volume ≤1.0 cm3. Tumors were distributed sequentially in the head and neck (77.2%), upper limbs (12.9%), trunk (7.6%), and lower limbs (2.3%). The correct rates of clinical and ultrasonic diagnosis were 50.9% and 38.6%, respectively. The two most common pathological features of pilomatrixoma were shadow cells (99.4%) and basaloid cells (94.7%). There were no significant differences in age, disease course, or tumor volume between the male and female patients (p > 0.05). The age and tumor volume of the patients in different body parts were significantly different (P1 = 3.10E-05 and P2 = 5.60E-05, respectively). The correlation between the disease course and tumor volume was positively significant (p ≤ 0.05). There was a significant correlation between the disease course and tumor volume in patients with tumors at upper limbs (p = 0.03).
Conclusion:
The age of children with pilomatrixoma presented 2 peaks and 2 valleys. Most patients had disease courses in 24 months and with tumor volumes ≤1.0 cm3. The correct rates of clinical and ultrasonic diagnosis were relatively low. The head and neck were the most common distribution sites of pilomatrixoma, and shadow cells and basaloid cells were the most common pathological features. The tumor volume was positively correlated with disease course in patients with pilomatrixoma.
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