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Earlobe Pilomatrixoma in Children: Clinical Features and Surgical Management
Abdullah Alkhaldi1,2, Reem Althwanay3, Abdullah Saad Alsalamah1,2
1Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, King Abdul-Aziz Medical City, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia.
Insights
Pilomatrixoma, a rare benign skin tumor in children, can present in unusual locations like the earlobe. Early recognition of its clinical features aids in effective surgical management and diagnosis.
Area of Science:
- Dermatology
- Pediatric Oncology
- Surgical Pathology
Background:
- Pilomatrixomas are common benign skin tumors in children, typically affecting the head and neck.
- Earlobe pilomatrixomas are rare, presenting diagnostic challenges due to potential resemblance to other auricle conditions.
- Clinical presentation includes firm, non-tender nodules, sometimes with discoloration.
Purpose of the Study:
- To report a rare case of pediatric earlobe pilomatrixoma.
- To outline the clinical presentation, surgical management, and histopathological findings.
- To emphasize pilomatrixoma in the differential diagnosis of pediatric head and neck masses.
Main Methods:
- Case report of a 6-year-old girl with a right earlobe mass.
- Clinical examination revealing a firm, non-tender, mobile lesion.
- Surgical excision followed by histopathological analysis.
Main Results:
- Histopathology confirmed pilomatrixoma with calcified areas, ghost cells, and giant cells.
- Absence of basaloid and transitional cells indicated lesion maturity.
- The lesion was successfully managed via surgical excision.
Conclusions:
- Pilomatrixoma should be considered in the differential diagnosis of pediatric auricle masses.
- Recognizing clinical features facilitates management and reduces unnecessary investigations.
- This case highlights an efficient diagnostic and management approach for unusual pilomatrixoma presentations.
Abstract:
BACKGROUND Pilomatrixomas are benign skin tumors that tend to occur in children. They most commonly arise in the head and neck region, but their appearance in the ear, especially the earlobe, is rare. Clinically, these lesions present as firm, non-tender nodules, occasionally with a reddish or bluish tint. Given the lesions' typical features, experienced clinicians may opt for surgical excision without extensive workup. Still, diagnosis can be challenging when the lesion is located in an unusual site, like the auricle, where it can resemble other skin conditions. In this report, we describe a case of earlobe pilomatrixoma and outline its clinical presentation, surgical management, and histopathological findings. CASE REPORT A 6-year-old girl presented with a painless, stable mass on her right earlobe, first noticed at the age of 3 years. Physical examination revealed a firm, non-tender, well-circumscribed, mobile lesion, with no overlying skin changes or history of trauma. No previous imaging or investigations were conducted. After discussion, surgical excision was performed. Histopathological analysis showed alternating eosinophilic and basophilic calcified areas, abundant anucleate eosinophilic ghost cells, and multinucleated giant cells, confirming pilomatrixoma. Notably, basaloid and transitional cells were absent, suggesting lesion maturity. CONCLUSIONS This case emphasizes the importance of considering pilomatrixoma in the differential diagnosis of pediatric head and neck masses and how it might even present in some unusual locations, such as the auricle. Recognizing its clinical features can facilitate effective management while minimizing unnecessary diagnostic tests. In this case, we highlighted an efficient approach and raised awareness of pilomatrixoma's distinctive presentation.
