J Korean Ophthalmol Soc.  2010 May;51(5):758-763.

Upper Lid Pilomatricoma: A Report of Four Cases

Affiliations
  • 1Department of Ophthalmology, Chungbuk National University College of Medicine, Cheongju, Korea. mychoi@chungbuk.ac.kr
  • 2Department of Pathology, Chungbuk National University College of Medicine, Cheongju, Korea.
  • 3Department of Radiology, Chungbuk National University College of Medicine, Cheongju, Korea.

Abstract

PURPOSE
Four patients who presented with an upper lid mass were diagnosed with pilomatricoma after excisional biopsy. We report the cases to improve the differential diagnoses of upper lid masses through investigation of the clinical manifestations and radiological findings of pilomatricoma.
CASE SUMMARY
Three females and one male with ages of six, seven, eight and 46 years, respectively, each presented with a slowly growing and painless upper lid mass of a three-month duration. In the six-year-old patient who had a history of trauma related to the mass, the mass was fixed to the skin, although the masses were movable in the other patients. Upon computed tomography (CT), well-circumscribed, enhancing nodules were found. Excisional biopsy was performed for definite diagnosis and treatment. All completely excised masses were hard and encapsulated with a thin membrane. The sizes of the masses were 12 mm, 10 mm, 10 mm, and 7 mm. Histopathologic examination with hematoxylin-eosin staining confirmed the masses to be pilomatricoma. There was no evidence of recurrence at 16, 2, 19, and 21 months after mass excision.
CONCLUSIONS
In patients presenting with a painless upper lid mass, pilomatricoma should be considered in the differential diagnosis.

Keyword

Lid; Pilomatricoma

MeSH Terms

Biopsy
Diagnosis, Differential
Female
Humans
Male
Membranes
Pilomatrixoma
Recurrence
Skin

Figure

  • Figure 1. Facial photographs show a mass in the upper eyelid (arrow). (A) Eyelid mass in the 6-year-old girl (case 1). (B) Eyelid mass in the 7-year-old boy (case 2). (C) Bluish skin-colored mass of the upper eyelid in the 8-year-old girl (case 3). (D) Movable eyelid mass in the 46-year-old woman (case 4).

  • Figure 2. Axial view of the orbit CT. (A) 12 mm-sized well circumscribed nodule with peripheral enhancement (arrow, case 1). (B) 7mm-sized well circumscribed, enhancing nodule in the subcutaneous fat layer (arrow, case 4).

  • Figure 3. Completely excised mass of case 1 was firm and encircled with pseudocapsule.

  • Figure 4. Histologic findings of mass of all cases are consistent with pilomatricoma. Irregular nets of phantom cells (arrow) with a calcification (asterisk) is shown. Among them, multinucleated giant cells with chronic inflammatory infiltrates (arrow head) are also seen (Hematoxylin-eosin staining, A; ×400, B; ×100).


Reference

References

1. Welch RB, Duke JR. Lesions of the Lids; a stastistical note. Am J Ophthalmol. 1958; 45:415–26.
2. Allington HV, Allington JH. Eyelid tumors. Arch Dermatol. 1968; 96:50–65.
Article
3. O'Brien CS, Braley AE. Common tumors of the eye lids. J Am Med Assoc. 1936; 107:993.
4. O'Grady RB, Spoerl G. Pilomatrixoma (benign calcifying epithelioma of Malherbe). Ophthalmology. 1981; 88:1196–7.
5. Orlando RB, Rogers GL, Bremer DL. Pilomatricoma in a pediatric hospital. Arch Ophthalmol. 1983; 101:1209–10.
Article
6. Headington JT. Tumors of the hair follicle. A review. Am J Pathol. 1976; 85:479–514.
7. Kleener J. Pilomatrixoma (epithelioma calcificans Malherbe). A abdominal and histopathological survey of Danish material from 1954 to 1971. Acta Ophthalmol. 1973; 51:692–9.
8. Malherbe A, Chenantais J. Note sur l'epitheliome calcifie des glandes sebacees. Prog Med. 1880; 8:826–8.
9. Taaffe A, Wyatt EH, Bury HP. Pilomatricoma. A clinical and abdominal survey of 78 cases. Int J Dermatol. 1988; 27:477–80.
10. Boniuk M, Zimmerman LE. Pilomatrixoma (benign calcifying abdominal) of the eyelids and eyebrow. Arch Ophthalmol. 1963; 70:399–406.
11. Forbis R, Helwig EB. Pilomatrixoma (calcifying epithelioma). Arch Dermatol. 1961; 83:606–8.
Article
12. Arnold HL. Pilomatricoma. Arch Dermatol. 1977; 113:1303.
Article
13. Choi CH, Chang HR, Kim MW. A case of pilomatrixoma of the eyelid. J Korean Ophthalmol Soc. 1992; 33:180–4.
14. Julian CG, Bowers PW. A clinical review of 209 pilomatricomas. J Am Acad Dermatol. 1998; 39:191–5.
Article
15. Duflo S, Nicollas R, Roman S, et al. Pilomatrixoma of the head and neck in children: A study of 38 cases and a review of literature. Arch Otolaryngol Head Neck Surg. 1998; 124:1239–42.
16. Ichikawa T, Nakajima Y, Fujimoto H, et al. Giant calcifying abdominal of Malherbe (pilomatrixoma): imaging features. Skeletal Radiol. 1997; 26:602–5.
17. Som PM, Shugar JM, Silvers AR. CT of pilomatrixoma in the cheek. AJNR Am J Neuroradiol. 1998; 19:1219–20.
18. Lee KH, Kim HJ, Suh CH. Pilomatricoma in the head and neck: CT findings in three Patients. J Comput Assist Tomogr. 2000; 24:332–5.
Article
19. Park SN, Cheun BC, Kim SW, et al. A case of pilomatricoma occurring in the ear lobule. J Clinical Otolaryngol. 2003; 14:299–301.
Article
20. De Beuckeleer LH, De Schepper AM, Neetens I. Magnetic resonance imaging of pilomatrixoma. Eur Radiol. 1996; 6:72–5.
21. Boyd AS, Martin RW. Pilomatricoma (calcified epithelioma of Malherbe) with secondary ossification. Arch Otolaryngol Head Neck Surg. 1992; 118:212–5.
22. Kaddu S, Soyer HP, Hodl S, Kerl H. Morphological stages of pilomatricoma. Am J Dermatopathol. 1996; 18:333–8.
Article
23. Rotenberg M, Laccourreye O, Cauchois R, et al. Head and neck pilomatrixoma. Am J Otolaryngol. 1996; 17:133–5.
Article
24. Colver GB, Buxton PK. Pilomatrixoma. An elusive diagnosis. Int J Dermatol. 1988; 27:177–8.
Article
25. Goufman DB, Murrell GL, Watkins DV. Pilomartricoma (calcifying epithelioma of Malherbe). Arch Otolaryngol Head Neck Surg. 2001; 127:218–20.
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