Clinical analysis and review of literature on pilomatrixoma in pediatric patients

Abstract

Background: Pilomatrixoma is a benign tumor that originates from the hair follicle matrix. It usually presents as a hard, slow growing, solitary mass that can be easily misdiagnosed as other skin masses. The aim of this study was to clinically analyze a case series of pilomatrixoma in pediatric patients from Korea. Methods: A total of 165 pediatric patients from 2011 to 2018 with a histological diagnosis of pilomatrixoma were included. A retrospective review was performed using the electronic medical records, including patient demographics, number and location of the mass, clinical and imaging presentation, and postoperative outcomes. Results: There were 61 male and 104 female patients with 152 solitary and 13 multiple pilomatrixomas. Among solitary pilomatrixomas, the lesion commonly occurred in the head and neck (84.2%), followed by upper limbs (11.2%), lower limbs (3.3%), and trunk (1.3%). The pilomatrixoma lesion presented as the following types based on our clinical classification: mass (56.02%), pigmentation (25.31%), mixed (12.65%), ulceration (4.82%), and keloid-like (1.2%). Ultrasonography showed a high positive predictive value (95.56%). There were no specific complications observed except for two cases of recurrence. Conclusion: Pilomatrixoma has various clinical feature presentations and commonly occurs in the head and neck. Ultrasonography is a helpful diagnostic tool. Surgical removal of the lesion is the main treatment method with a low recurrence rate.

A retrospective investigation of twenty-five cases with periocular pilomatrixoma

“…Pilomatrixoma were mostly found in female patients in the rst 2 decades of their lives [1]. Our ndings here were in accordance with the conclusions before (female: 56 %,younger than 20 years: 56 %).…”

“…Pilomatrixoma, a rare hair follicle matrix-derived benign tumor, always presents in the head and neck in pediatric populations [1]. In 1880, Malherbe and Chenantais rst described it as "calcifying epithelioma of Malherbe".…”

“…Clinically, the diagnosis of periocular pilomatrixoma is somehow di cult given the similarity of their appearance to other dermal masses, such as chalazion [5,6]. Therefore, histological examinations upon complete surgical resection are essential for the con rmation of such conditions [1]. Till now, most of the periocular pilomatrixoma are reported as case reports around the world.…”

Giant Pilomatrixoma of the Scrotum: A Rare Case Presentation

“…Based on appearance, a pilomatrixoma lesion can be classified into five clinical types: protruding mass, pigmented, mixed type, ulcerated, and keloid-like. The mass type is a predominant presentation in the available literature [9]. Four stages of the histomorphological pattern were explained by Kaddu et al as early, fully developed, early regressive, and late regressive stages [5].…”

“…USG is acceptable enough in the majority of the cases with a positive predictive value of 95.5% since it is quick, cheap, and easily available. The definitive diagnosis of pilomatrixoma is, however, made by histopathological examination [9]. On histology, the tumor is well-defined, comprising of peripheral basaloid cells proliferation and centrally located structureless eosinophilic cells, which lack nuclei called shadow cells or ghost cells typical of trichilemmal keratinization.…”