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Table of Contents
CLINICAL CASE
Year : 2015  |  Volume : 17  |  Issue : 2  |  Page : 77-79

Pediatric cheek pilomatrixoma case report


1 Consultant, Department ORL-HN, Khamees Mushayt General Hospital, Khamees Mushayt, Saudi Arabia
2 Resident, Department ORL-HN, Khamees Mushayt General Hospital, Khamees Mushayt, Saudi Arabia

Date of Web Publication2-Jan-2020

Correspondence Address:
Ahmad Ali Etwadi
Ahmad Etwidi ORL-HNS Consultant, Khamees Mushayt General Hospital, Khamees Mushayt Saudi Arabia
Saudi Arabia
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1319-8491.274663

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  Abstract 


Objective: A 12 year old girl with right cheek mass for 10 months with pain and redness was seen. The swelling was adherent to the skin, mobile over the underlying structures, with mild tenderness. The mass excised and hitopathologically was pilomarixoma.

Keywords: Pilmatrixoma, skin appendages, cheek mass


How to cite this article:
Etwadi AA, Sumaily I. Pediatric cheek pilomatrixoma case report. Saudi J Otorhinolaryngol Head Neck Surg 2015;17:77-9

How to cite this URL:
Etwadi AA, Sumaily I. Pediatric cheek pilomatrixoma case report. Saudi J Otorhinolaryngol Head Neck Surg [serial online] 2015 [cited 2022 Dec 8];17:77-9. Available from: https://www.sjohns.org/text.asp?2015/17/2/77/274663




  Introduction Top


Pilomatrixoma is one of the benign tumors that arise from hair follicles, and is to some extent considered a rare mass in head and neck and therefore rarely seen by otoloaryngologist in comparison to dermatologist. Here we present a child with pilomatrixoma in the right cheek.


  Case History Top


A 12 years old girl, medically free, presented with right check lump slowly progressive for 10 months associated with on/off redness and mild pain. No discharge or trismus. No family history.

General physical examination revealed a well looking athletic patient, vitally stable, and normal on neurologic and systemic examination. Locally; right check mass 2 x 3 cm was seen. It was mildly tender, adherent to the covering skin with dimpling, mobile over the underlying structures [Figure 1]. Bimanually, there was a mobile mass lateral to the retromolar trigone, with intact mucosa. No palpable cervical lymph nodes were found. Normal other head and neck examination.
Figure 1: Clinical presentation of the case by mass on the cheeck.

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Investigations: normal routine laboratory investigations. Radiologically Computed Tomography (CT) of the neck revealed a hypodense subcutaneous mass, 2 x 3 cm lateral to the right masseter muscle.

Fine Needle Aspiration Cytology (FNA): the aspirate showed ghost cells with calcium deposits.

The mass excised in the operative room (OR) under general anaesthesia with preservation of most of the covering skin and the wound edges weresutured [Figure 2].
Figure 2: Wound after compelete excesion of the mass

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The patient was reviewed at outpatient clinic seven days postoperatively for stitch removal He was followed up every three months for up to one year with no obvious deformity or recurrence.

Histopathology: the mass sections showed scattered islands of ghost cells and shadow or basalloid cells in a dense of fibrous tissue with evidence of reactive non-specific granulamatous inflammation, infiltrate of mononuclear inflammatory cells and scattered foreign body giant cells. And on the bases of clinical and histopathological finding, the diagnosis of pilomatrixoma established [Figure 3].
Figure 3: Histopathology: the mass sections showed ghost cells, basalloid cells, mononuclear cells, non-specific granulomas and scattered foreign body giant cells

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  Discussion Top


Pilomatricoma (also called pilomatrixoma) is a benign tumor originating from the matrix of the hair root 3. It was first described by Malherbe and Chenantais in 1880 [1], when it though as a sebaceous gland tumor. But in 1961 Forbis and Helwig studied this tumor histological well and documented the origin of it to be from the skin matrix [2]. Its incidence is more in childhood with female:male ratio of 3:2 and higher racial prevalence in Caucasian [3],[4].

It usually presents as a slowly growing single firm mass of clear margins, sometimes with recurrent symptoms of local inflammation. This mass is adherent to the skin but mobile in all directions, and normal to inflamed and infected covering skin [5]. It is very rarely a pilomatrixoma carcinoma and extremely rare to have a distntl metastasis [6].

Its diagnosis is usually established on clinical finding and FNA versus incisional or excisional biopsy [7].

Its management is surgical excision and in most of the times a part of the overlying skin is excised because it is very adherent to the mass as well then the edges either approximated or a local flap is utilized [8]. If excised completely, recurrence rate is very rare [9].

In our patient the clinical finding, radiological and laboratory findings were all classic for pilomatrixoma which confirmed by histopathological diagnostic features. Surgery was curative for the case as with the follow up there was no residual mass or recurrence.



 
  References Top

1.
Malherbe A, Chenantais J. Note sur l’ epithelioma calcifie des glandes sebacees. Prog Med. 1880; 8:826-8.  Back to cited text no. 1
    
2.
Forbis R, Helwig EB. Pilomatricoma (calcifying epithelioma) Arch Dermatol 1961; 83:606-18.  Back to cited text no. 2
    
3.
Ichikawa T, Nakajima Y, Fujimoto H et al. Giant calcifying epithelioma of Malherbe (pilomatrixoma): imaging features. Skeletal Radiol. 1997; 26: 602-5.  Back to cited text no. 3
    
4.
F. W. Moehlenbeck, “Pilomat rixoma (calcify ing epithelioma). A statistical study, “ Arch Derm. 1973; 108(4):532- 534.  Back to cited text no. 4
    
5.
Lan MY, Lan MC, Ho CY et al. Pilomatricoma of the head and neck: a retrospective review of 179 cases. Arch Otolaryngol Head Neck Surg. 2003; 129: 1327-30.  Back to cited text no. 5
    
6.
Scheinfeld N. Pilomatrical carcinoma: a case in a patient with HIV and hepatitis C. Dermatol Online J. 2008; 14:4.  Back to cited text no. 6
    
7.
Yencha MW. Head and neck pilomatricoma in the pediatric age group: a retrospective study and literature review. Int J Pediatr Otorhinolaryngol. 2001; 57: 123-8.  Back to cited text no. 7
    
8.
Agarwal RP, Jandler SD, Mattews MR, Carpentieri D. Pilomatrixoma of the head and neck in children. Otolaryngol Head Neck Surg. 2001; 125:510-5.  Back to cited text no. 8
    
9.
Cohen AD, Lin SJ, Hughes CA, An YH, Maddalozzo J. Head and neck Pilomatrixoma in children. Arch Otolaryngol Head Neck Surg. 2001; 127:1481-3.  Back to cited text no. 9
    


    Figures

  [Figure 1], [Figure 2], [Figure 3]



 

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