Pathological Case of the Month

Pilomatrixoma of the Head and Neck in Children

“…In most cases, the lesions are poorly delineated, but encapsulated forms have also been observed. 6,15 Recurrence is less likely with encapsulated lesions because complete resection is easier. The reported incidence of calcification ranges from 69% to 85%, 10,13 and bone metaplasia is observed in 15% of cases, presumably owing to conversion of fibroblasts into osteoblasts.…”

“…Pilomatrixoma usually occurs within the first 2 years of life. [4][5][6] The most frequent anatomical location is the head and neck region. 4 Most cases involve single nodules, 2,7 but multiple occurrences have been reported.…”

“…8,9 Typically, pilomatrixomas are benign but have a ten-dency to recur if not completely resected. 5,6 A few cases of malignant pilomatrixoma 9,11,12 metastasizing to the lung, bone, brain, abdominal organs, skin, and lymph nodes 11 have been described.…”

Preauricular pilomatrixoma in a 3 year-old girl: A case study

“…Complete surgical excision of the tumor is the recommended treatment although Morales and Mc Goey reported they successfully treated eight patients with incision and curettage of large lesions on exposed sites 11 . Following excision, pilomatrixoma recurrence is relatively rare, with overall rates of 2.6% in a large series of patients [2][3][4][5][6] . In the event that a lesion does recur, the physician should suspect pilomatrixoma carcinoma 4,5,9 .…”

“…Treatment consists of surgical excision. Recurrences are rare, but when they do occur, the physician should suspect a malignant pilomatrixoma variant 3,5 . Because most case descriptions are reported in the dermatology literature, otolaryngologists might not be familiar enough with the condition to include it as a differential diagnosis.…”