Clinical Characteristics of Pilomatricoma in the Head and Neck

Tae, Kyung; Keum, Hyo Sub; Lee, Dong Wok; Jeong, Jin Hyeok; Cho, Seok Hyun; Park, Dong Woo; Oh, Young Ha

Abstract

BACKGROUND AND OBJECTIVES: Pilomatricoma, also known as calcifying epitheliomas of Malherbe is uncommon, benign skin neoplasm that arise from outer root sheath cell of hair follicle or hair follicle of sebaceous glands. In more than half of the cases, pilomatricoma typically involves the head and neck followed by upper extremities and trunk, with the majority occurring in children. The purpose of this study is to analyze the data from the author's experience with head and neck pilomatricoma and to discuss diagnostic and therapeutic management.
SUBJECTS AND METHOD
A retrospective analysis of the patients of pilomatricoma treated between 1994 and 2004 revealed 21 cases of head and neck pilomatricoma.
RESULTS
The typical clinical manifestation of pilomatricoma was non-tender, firm, subcutaneous, and nodular mass. The age range was from 9 months to 62 years (mean 17.4 years). The male-to-female ratio was 4 : 3. The common sites of occurrence were the neck (33%), cheek (24%), suboccipital (14%), preauricular (14%). The size of the mass ranged from 0.5 cm to 3 cm, and the mean was 1.1 cm. CT with contrast enhancement scans revealed densely calcified, mild enhancing and well circumscribed soft tissue densities in subcutaneous tissues. Additionally, MRI with gadolinum enhancement scans revealed partially enhanced, well demarcated and intermediate signal intensity mass lesions. Surgical excision was curative in all cases.
CONCLUSION
Pilomatricoma is cutaneous neoplasms that occur commonly in the head and neck region. Even if the preoperative diagnosis may be difficult in some cases, pilomaticoma must be considered in the differential diagnosis of a superficial head and neck mass.