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Ciriacks K, Knabel D, Waite MB. Syndromes associated with multiple pilomatricomas: When should clinicians be concerned? Pediatr Dermatol 2020; 37:9-17. [PMID: 31618803 DOI: 10.1111/pde.13947] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Multiple pilomatricomas have been linked to various syndromes. However, these associations are poorly defined, leaving practitioners conflicted on management of these patients. OBJECTIVE To perform a comprehensive review to clarify the strength of these relationships and identify which patients may benefit from additional screening and/or genetic screening. METHODS A literature search was performed using the PubMed, Ovid, and Cochrane databases. Syndromic, familial, and sporadic cases of multiple pilomatricomas were stratified based on number of pilomatricomas. This information was graphed for visual comparison. RESULTS Sixty-six syndromic cases from 52 publications were identified, with the majority (54) of cases representing myotonic dystrophy, familial adenomatous polyposis-related syndromes (including Gardner syndrome), Turner syndrome, or Rubinstein-Taybi syndrome. Twenty-five of the 54 cases (46.3%) had six or more pilomatricomas. Of sporadic cases, 128 out of 134 (95.5%) had five or less pilomatricomas. LIMITATIONS Most articles were case reports and series, which are vulnerable to publication bias. Specific details were not explicitly noted in some original articles, and incomplete data could not always be included in analysis. Syndromes may have been missed in sporadic cases. CONCLUSION The presence of six or more pilomatricomas is highly suggestive of an underlying syndrome (>95% specificity). These patients should undergo additional screening. Patients with less than six pilomatricomas and family history of myotonic dystrophy, first-degree relative with colon cancer or FAP-related syndrome, or family history of pilomatricomas should also undergo further screening.
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Affiliation(s)
- Kevin Ciriacks
- Dermatology Resident, University of North Carolina, Chapel Hill, North Carolina
| | - Daniel Knabel
- Dermatology Resident, Cleveland Clinic, Cleveland, Ohio
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2
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An Unusual Tumor of the Ear: Pilomatricoma in a Middle-Aged Woman. Case Rep Otolaryngol 2019; 2019:4975216. [PMID: 31915560 PMCID: PMC6931023 DOI: 10.1155/2019/4975216] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Accepted: 11/28/2019] [Indexed: 11/24/2022] Open
Abstract
Pilomatricoma is a benign tumor arising from hair follicle matrix cells, presenting as an asymptomatic, firm, slow growing, mobile, superficial skin nodule typically in children. This lesion with an atypical clinical presentation is frequently misdiagnosed as other skin lesions and even as malignant entities regardless of detailed cytological, imaging examinations; the site of occurrence is one of the keys to accurate diagnosis. Here, we present a case of pilomatrixoma involving the ear, the cymba conchae of the auricle, which is an extremely rare site for the lesion in a 52-year-old woman. The present case suggests that this benign tumor needs to be included in the differential diagnosis in patients who present with an atypical auricular lesion.
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Tang PP, Kalimuthu S, Mokhtar SM, Wahab SA. Preauricular Pilomatricoma Manifesting as an Aggressive Mass. Oman Med J 2019; 34:160-163. [PMID: 30918611 PMCID: PMC6425055 DOI: 10.5001/omj.2019.29] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Pilomatricoma is an uncommon benign skin tumor arising from the hair follicle. It usually occurs in the head and neck region and is typically found in the pediatric age group particularly girls. The tumor has inconsistent clinical features and may manifest as a small superficial lesion with benign features or a large and seemingly aggressive lesion with local invasion. Due to its variable clinical presentations, it can occasionally be misdiagnosed as a malignant tumor. We encountered a case of pilomatricoma in a 12-year-old girl with a left preauricular swelling for two years, which became progressively larger and more painful in the few weeks before presentation. Clinically, the swelling resembled a malignant parotid tumor. Multiple fine-needle aspirations were performed, but the cytology results were all inconclusive. Subsequent computed tomography scan revealed a well-defined calcified subcutaneous mass with suspicious parotid involvement. The case was posted for tumor excision and superficial parotidectomy. Intraoperatively, however, the mass could be easily separated from the parotid gland. Histopathological examination of the excised specimen showed characteristic ghost cells, basophilic cells, and ossifications typical of pilomatricoma. In conclusion, preauricular pilomatricoma may pose a diagnostic dilemma. A heightened knowledge of the disease is needed for early recognition of its clinical and imaging features to prevent aggressive therapy than is required.
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Affiliation(s)
- Phing Phing Tang
- Department of Otorhinolaryngology, Tengku Ampuan Rahimah Hospital, Selangor, Malaysia
| | - Santhi Kalimuthu
- Department of Otorhinolaryngology, Tengku Ampuan Rahimah Hospital, Selangor, Malaysia
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4
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Pinheiro TN, Fayad FT, Arantes P, Benetti F, Guimarães G, Cintra LTA. A new case of the pilomatrixoma rare in the preauricular region and review of series of cases. Oral Maxillofac Surg 2018; 22:483-488. [PMID: 30284072 DOI: 10.1007/s10006-018-0724-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Accepted: 09/26/2018] [Indexed: 06/08/2023]
Abstract
Pilomatrixoma is considered a rare benign tumor arising from the hair follicle, most common in the head and neck region, but it is rarely diagnosed on a clinical basis. This report describes a new case of giant pilomatrixoma in a 36-year-old female patient. The nodule was localized in the preauricular area on the right side, appearing as a slow-growing, fixed, painless, with a hardened consistency, unusual giant (4.5 cm). A cone-beam computed tomography (CBCT) examination showed a slightly hyperdense lesion, and fine-needle aspiration cytology (FNAC) revealed peripheral blood and mononucleated inflammatory cells. After enucleation of lesion, a diagnosis of pilomatrixoma was confirmed. The differential diagnosis of pilomatrixoma is broad, because its characteristics also can be found in other lesions common to the head and neck. Thus, a lesion in the head and neck, adherent to the skin, and well demarcated, mainly in the young and in females, should be suspected as pilomatrixoma.
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Affiliation(s)
- Tiago Novaes Pinheiro
- Oral Pathology and Oral Medicine, Amazonas State University, Manaus, AM, 69050-010, Brazil
| | | | - Pedro Arantes
- Maxilofacial Surgery, Amazonas State University Maxilofacial Surgery Residency, Manaus, AM, 69050-010, Brazil
| | - Francine Benetti
- Endodontics, School of Dentistry, São Paulo State University (Unesp), Araçatuba, SP, 16015-050, Brazil
| | - Gustav Guimarães
- Periodontics, School of Dentistry, University Center São Lucas, Porto Velho, RO, 76804- 295, Brazil
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Avignon S, Foletti JM, Collet C, Guyot L, Chossegros C. [Calcifications of the parotid space. A review]. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2017; 118:167-172. [PMID: 28391078 DOI: 10.1016/j.jormas.2017.03.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/10/2015] [Revised: 11/22/2016] [Accepted: 03/15/2017] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Parotid lithiasis is the main cause of calcifications in the parotid space. However, there are many other less known causes. The aim of our study was to point out the non-lithiasic causes of calcifications in the parotid space. MATERIAL AND METHODS We conducted an exhaustive review of the literature by mean of PubMed, using the keywords "parotid" and "calcification" and limiting our analysis to the original articles in humans published in English and in French. Articles reporting about microscopic calcifications and who were not dealing with parotid calcifications were excluded. RESULTS Twenty articles met the inclusion criterions. Tumoral and non-tumoral local causes and systemic causes of parotid calcification were found. The way they revealed was variable. The main tumoral local causes were pleomorphic adenomas, salivary duct carcinomas and adenocarcinomas. The main non-tumoral local causes included vascular malformations and calcified parotid lymph nodes. The main systemic causes were chronic kidney diseases, HIV infection, chronic alcoholism, elevated levels of alkaline phosphatase and auto-immune diseases. DISCUSSION Eighteen different etiologies of parotid space calcifications could be identified. First line exploration of these lesions relies mainly on conventional radiography and ultrasound examination that are easily available. CT scan remains the reference examination.
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Affiliation(s)
- S Avignon
- Service de stomatologie et de chirurgie maxillo-faciale, CHU de la Timone, AP-HM, 264, rue Saint-Pierre, 13385 Marseille cedex 5, France.
| | - J-M Foletti
- Service de chirurgie maxillo-faciale, stomatologie et plastique, hôpital Nord, chemin des Bourrelys, 13015 Marseille, France
| | - C Collet
- Service de stomatologie et de chirurgie maxillo-faciale, CHU de la Timone, AP-HM, 264, rue Saint-Pierre, 13385 Marseille cedex 5, France
| | - L Guyot
- Service de chirurgie maxillo-faciale, stomatologie et plastique, hôpital Nord, chemin des Bourrelys, 13015 Marseille, France
| | - C Chossegros
- Service de stomatologie et de chirurgie maxillo-faciale, CHU de la Timone, AP-HM, 264, rue Saint-Pierre, 13385 Marseille cedex 5, France
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Jáuregui E, Kiringoda R, Ryan WR, Eisele DW, Chang JL. Chronic parotitis with multiple calcifications: Clinical and sialendoscopic findings. Laryngoscope 2016; 127:1565-1570. [PMID: 27861944 DOI: 10.1002/lary.26386] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2016] [Revised: 09/01/2016] [Accepted: 09/27/2016] [Indexed: 12/13/2022]
Abstract
OBJECTIVES/HYPOTHESIS To characterize clinical, imaging, and sialendoscopy findings in patients with chronic parotitis and multiple parotid calcifications. STUDY DESIGN Retrospective review. METHODS Clinical history, radiographic images and reports, lab tests, and operative reports were reviewed for adult patients with chronic parotitis and multiple parotid calcifications who underwent parotid sialendoscopy. RESULTS Thirteen of 133 (10%) patients undergoing parotid sialendoscopy for chronic sialadenitis had more than one calcification in the region of the parotid gland. Seven patients (54%) were diagnosed with immune-mediated disease from autoimmune parotitis (positive Sjögren's antibodies or antinuclear antibodies) or human immunodeficiency virus (HIV) disease. The six patients (46%) who did not have an immune-mediated disorder had most calcifications located anterior or along the masseter muscle. Eight of 13 patients (61%) had at least one calculus found in the parotid duct on sialendoscopy. Four patients (38%) had multiple punctate calcifications within the parotid gland, all of whom had either autoimmune parotitis or HIV. None of the proximal or punctate parotid calcifications posterior to the masseter were visualized on sialendoscopy. CONCLUSIONS Chronic parotitis in conjunction with multiple parotid calcifications is uncommon and was identified in 10% of our cohort. We contrast two classifications of parotid calcifications: 1) intraductal stones that cause recurrent duct obstruction and are often located within the main parotid duct along or anterior to the masseter and 2) punctate intraparenchymal parotid gland calcifications that are not visualized on sialendoscopy and may represent underlying inflammatory disease. LEVEL OF EVIDENCE 4 Laryngoscope, 127:1565-1570, 2017.
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Affiliation(s)
- Emmanuel Jáuregui
- Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco School of Medicine, San Francisco, California, U.S.A
| | - Ruwan Kiringoda
- Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, U.S.A
| | - William R Ryan
- Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco School of Medicine, San Francisco, California, U.S.A
| | - David W Eisele
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins School of Medicine, Baltimore, Maryland, U.S.A
| | - Jolie L Chang
- Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco School of Medicine, San Francisco, California, U.S.A
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7
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Schwarz Y, Pitaro J, Waissbluth S, Daniel SJ. Review of pediatric head and neck pilomatrixoma. Int J Pediatr Otorhinolaryngol 2016; 85:148-53. [PMID: 27240514 DOI: 10.1016/j.ijporl.2016.03.026] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2016] [Revised: 03/16/2016] [Accepted: 03/18/2016] [Indexed: 10/22/2022]
Abstract
INTRODUCTION Pilomatrixoma is a benign skin tumor, which is commonly found in the head and neck region. It usually presents as an isolated lesion and rarely undergoes malignant transformation. It is not uncommon for these tumors to be misdiagnosed. OBJECTIVE To review the clinical characteristics of head and neck pilomatrixomas in the pediatric population. METHODS A systematic review was completed by searching ten databases to identify studies reporting findings on pilomatrixoma in the pediatric population. Eligible articles were independently assessed for quality by two authors. RESULTS A total of 17 studies met the inclusion criteria totaling 318 pediatric patients. The age of diagnosis ranged from 3 months to 17 years of age. The female to male ratio was 1.65:1. In 14 articles, in which pilomatrixoma was located in the head and neck region, 76 (25%) lesions were found in the neck while 229 (75%) were present in the head region. Three articles exclusively described ophthalmologic pilomatrixoma. Even though pilomatrixoma presents with classical features, the clinical diagnostic accuracy when confronting this lesion averaged 43%. The definitive treatment was surgical excision with a very low recurrence rate. CONCLUSION Head and neck pilomatrixoma in the pediatric population has a typical presentation with a low clinical diagnostic accuracy. Awareness of this lesion and its clinical appearance can improve its diagnosis. We hereby suggest a management algorithm for suspected pilomatrixoma.
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Affiliation(s)
- Yehuda Schwarz
- Department of Otolaryngology-Head and Neck Surgery, The Montreal Children's Hospital, McGill University Health Centre, Montreal, Quebec, Canada
| | - Jacob Pitaro
- Department of Otolaryngology-Head and Neck Surgery, The Montreal Children's Hospital, McGill University Health Centre, Montreal, Quebec, Canada
| | - Sofia Waissbluth
- Department of Otolaryngology-Head and Neck Surgery, The Montreal Children's Hospital, McGill University Health Centre, Montreal, Quebec, Canada
| | - Sam J Daniel
- Department of Otolaryngology-Head and Neck Surgery, The Montreal Children's Hospital, McGill University Health Centre, Montreal, Quebec, Canada.
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8
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9
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Kang JS, Tak MS, Kang SG, Jin SY. A Recurrent Giant Pilomatricoma on the Back. Arch Craniofac Surg 2014; 15:142-144. [PMID: 28913209 PMCID: PMC5556733 DOI: 10.7181/acfs.2014.15.3.142] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2014] [Revised: 07/23/2014] [Accepted: 08/01/2014] [Indexed: 12/01/2022] Open
Affiliation(s)
- Jin Seok Kang
- Department of Plastic and Reconstructive Surgery, Soonchunhyang University Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
| | - Min Sung Tak
- Department of Plastic and Reconstructive Surgery, Soonchunhyang University Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
| | - Sang Gue Kang
- Department of Plastic and Reconstructive Surgery, Soonchunhyang University Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
| | - So Young Jin
- Department of Pathology, Soonchunhyang University Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
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10
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Clinical pathologic conference case 1: a woman with a lump in her cheek. Oral Surg Oral Med Oral Pathol Oral Radiol 2013; 115:e34-6. [PMID: 23738342 DOI: 10.1016/j.oooo.2013.01.044] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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11
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Abdeldayem M, Mekhail P, Farag M, Shehata G, Al Sheikh M, Izzidien A, Naguib N. Patient profile and outcome of pilomatrixoma in district general hospital in United kingdom. J Cutan Aesthet Surg 2013; 6:107-10. [PMID: 24023435 PMCID: PMC3764756 DOI: 10.4103/0974-2077.112674] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Introduction: A pilomatrixoma is a benign appendage tumour related to hair cells matrix. Most of the literature review about pilomatrixoma is in the form of case reports with fewer cohort studies. The objective of this cohort is to study the variable demographic characteristics, presentation and histopathology of this condition among a larger group of patients. Materials and Methods: We conducted a retrospective study of patients who had excision of pilomatrixoma between February 1998 and August 2011 in a District General Hospital in UK. Results: The study included 67 patients with histopathologically diagnosed pilomatrixoma. The mean age was 32 years. Male to Female ratio was 35:32. The average diameter of the lesion at presentation was 13 mm (range: 2–30 mm). 66 of 67 (98.5%) patients presented with solitary lesion, while 1 patient (1.5%) had two lesions. Conclusion: Pilomatrixoma is not an uncommon benign lesion. It is more common in the maxillofacial area.
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12
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Souto MPA, Matsushita MDM, Matsushita GDM, Souto LRM. An unusual presentation of giant pilomatrixoma in an adult patient. J Dermatol Case Rep 2013; 7:56-9. [PMID: 23858343 DOI: 10.3315/jdcr.2013.1141] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2013] [Accepted: 05/02/2013] [Indexed: 11/11/2022]
Abstract
BACKGROUND Pilomatrixoma (OMIM ID #132600) is a benign cutaneous tumor originating from the pilosebaceous follicle and characterized by the presence of subcutaneous nodules of up to 3.0 cm in diameter, usually on the head, neck and upper extremities. It is most common in the first two decades of life and after the age of 60. MAIN OBSERVATIONS An adult female patient was evaluated, presenting a solid tumoral lesion with erythematous surface and purplish tone, with approximately 7.5 x 5.0 cm in size, in the interscapulovertebral region. It was thought to be an epidermoid cyst, sarcoma, calcified hemangioma, giant dermatofibroma, or nodular basal cell carcinoma. The resection of the lesion was carried out and, at the histological examination, specific details were observed that led to the diagnosis of pilomatrixoma. CONCLUSION Pilomatrixoma should be suspected in the differential diagnosis of giant adnexal tumors.
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Affiliation(s)
- Mariam Patrícia Auada Souto
- Department of Clinical Medicine, School of Medical Sciences, Universidade de Marília (UNIMAR), Marília, São Paulo state, Brazil
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13
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Martin BR, Neiderer K, Dancho JF. Pilomatrixoma: an infrequently encountered lesion on the lower extremity. J Am Podiatr Med Assoc 2013; 102:417-8. [PMID: 23001736 DOI: 10.7547/1020417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
We discuss the clinical presentation and treatment of pilomatrixoma as it occurs in the lower extremity. Although pilomatrixoma is far more common on the head, neck, and upper extremity, it can be found on the lower extremity. Treatment is aimed primarily at excision if the lesion is symptomatic or suspicious for malignancy. The authors present a case of a 73-year-old male who presented to the diabetic foot center with this condition.
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Affiliation(s)
- Billy R Martin
- Department of Surgery, Southern Arizona VA Health Care System, Tucson, Arizona, USA
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14
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Nguyen J, Palacios E, Horam E, Neitzschman H. Unusual parapharyngeal acinic cell carcinoma. EAR, NOSE & THROAT JOURNAL 2012; 91:16-20. [PMID: 22278862 DOI: 10.1177/014556131209100105] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Jeremy Nguyen
- Department of Radiology, Tulane University Hospital and Clinics, New Orleans, LA, USA
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15
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Malignant pilomatricoma in a dog. J Comp Pathol 2012; 147:214-7. [PMID: 22520811 DOI: 10.1016/j.jcpa.2012.01.019] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2011] [Revised: 01/15/2012] [Accepted: 01/23/2012] [Indexed: 11/20/2022]
Abstract
An 11-year-old female German shepherd dog was presented with a history of lameness and pain in the left forelimb. Clinical examination revealed ataxia of the hindlimbs and a subcutaneous mass in the left prescapular region. Radiography revealed metastatic foci in the left humerus, lung and abdomen. Gross necropsy examination revealed a firm, white mass in the left prescapular region. Multiple nodules with similar characteristics were observed in the lung, liver and spleen. Bone lysis was noted in the humerus and the fifth to seventh lumbar vertebrae. Microscopical examination revealed a proliferation of basal cells forming irregular islands of various sizes and surrounding extensive zones of keratinized 'ghost' cells. A definitive diagnosis of malignant pilomatricoma was made. This is a rare tumour in dogs with no previous report of metastasis to the spleen and liver.
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Abstract
Dystrophic calcification is deposition of calcium salt in degenerated tissues in the presence of normal calcium and phosphorous metabolism. It usually occurs in injured tissues. The condition may be associated with a variety of systemic disorders. The pathophysiology is still unclear. The case of a 17-year-old boy with dystrophic calcifications over the right masseter muscle is presented here with review of literature. Calcified nodules were surgically excised via an intraoral approach.
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Affiliation(s)
- Syed Ahmed Mohiuddin
- Department of Oral and Maxillofacial Surgery, MIDSR Dental College and Hospital, Latur, Maharashtra, India
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17
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O’Connor N, Patel M, Umar T, Macpherson D, Ethunandan M. Head and neck pilomatricoma: an analysis of 201 cases. Br J Oral Maxillofac Surg 2011; 49:354-8. [DOI: 10.1016/j.bjoms.2010.06.002] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2010] [Accepted: 06/03/2010] [Indexed: 12/01/2022]
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Abstract
Pilomatricoma is a benign skin tumor derived from the hair follicle, usually located in the head and neck and presenting in the first two decades of life. Clinically it most commonly presents as a hard, mobile, well circumscribed nodule. Microscopically it is characterized by the presence of shadow cells and may show calcification, while extensive ossification is rare. Surgical removal is the treatment of choice, as the recurrence rate is very low. We present a rare case of late regressive pilomatricoma of the arm in a 33 year old female which presented with extensive ossification.
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El Ibrahimi A, Daoudi A, Znati K, Elmrini A, Boutayeb F. [Insulated leg pilomatrixoma: a rare localization]. ANN CHIR PLAST ESTH 2009; 54:388-91. [PMID: 19195758 DOI: 10.1016/j.anplas.2008.09.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2008] [Accepted: 09/21/2008] [Indexed: 11/19/2022]
Abstract
Pilomatrixoma is a benign skin neoplasm of the hair follicle. It's common in the pediatric population. It's usually misdiagnosed and confused with other skin lesions. Head and neck represent the usual locations. The extremity remains an exceptional location. Through an observation of a pilomatrixoma of the leg in an adult patient treated surgically without recurrence, different diagnostic and therapeutic aspects of this pathology will be recalled.
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Affiliation(s)
- A El Ibrahimi
- Service de chirurgie orthopédique, hôpital Al-Ghasssani, CHU Hassan-II, Fès, Maroc.
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20
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Levy J, Ilsar M, Deckel Y, Maly A, Anteby I, Pe'er J. Eyelid Pilomatrixoma: A Description of 16 cases and a Review of the Literature. Surv Ophthalmol 2008; 53:526-35. [DOI: 10.1016/j.survophthal.2008.06.007] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Kovacic M, Rudic M, Nekic I, Lisica-Sikic N, Kranjcec Z, Simurina T. Giant Pilomatrixoma (Benign Calcifying Epithelioma of Malherbe) of the Neck and Face. Dermatol Surg 2007; 33:340-3. [PMID: 17338693 DOI: 10.1111/j.1524-4725.2007.33070.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Marijan Kovacic
- Department of Otorhinolaryngology, General Hospital Zadar, Zadar, Croatia
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23
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Giant Pilomatrixoma (Benign Calcifying Epithelioma of Malherbe) of the Neck and Face. Dermatol Surg 2007. [DOI: 10.1097/00042728-200703000-00013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Al-Khateeb TH, Hamasha AAH. Pilomatricoma of the Maxillofacial Area in the Northern Regional Jordanian Population: Report of 31 Cases. J Oral Maxillofac Surg 2007; 65:261-6. [PMID: 17236931 DOI: 10.1016/j.joms.2005.07.018] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2005] [Revised: 04/19/2005] [Accepted: 07/19/2005] [Indexed: 11/17/2022]
Abstract
PURPOSE To analyze the clinicopathologic features of pilomatricoma affecting the maxillofacial area in Jordanians. PATIENTS AND METHODS Records of the Department of Pathology at Jordan University of Science and Technology were reviewed for patients with biopsied pilomatricoma of the maxillofacial region received during the 11-year period extending between 1991 and 2001. These were retrieved, reviewed, and analyzed for age, gender, location, clinical features, and treatment. RESULTS There were 31 cases with an age range from 4 to 48 years (mean, 16.7). The majority (74%) of patients were in their first (45%) and second (29%) decades of life with a male to female ratio of 1 to 1.4. The periorbital (36%), the periauricular (28%), and the upper cervical region (23%) were the affected areas. The majority of cases presented as a painless skin nodule with a duration varying from 2 months to 3 years. The majority (97%) of tumors were between 0.5 cm and 2 cm in diameter. Histologically, almost 50% of tumors showed shadow cells alone. All tumors were removed surgically. CONCLUSIONS The clinicopathologic characteristics of pilomatricoma of the maxillofacial area in Jordanians are similar generally to those in other countries. Maxillofacial surgeons need to be more aware of this lesion and should consider it in the differential diagnosis of dermal masses they encounter.
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Abstract
We describe a pilomatricomal horn on the right arm of a 39-year-old man. Although initially the tumor was clinically thought to be a verruca vulgaris, the microscopic features were similar to those found in classic pilomatricoma, except for the epidermal location and the presence of a cutaneous horn. Light microscopy showed replacement of the epidermis by basaloid cells, with masses of cornified material containing shadow cells that formed a cutaneous horn. Whereas classic pilomatricoma is confined to the deep reticular dermis or subcutis, the present case represents a unique heretofore unreported epidermal variant of pilomatricoma that pathologists should be aware of to differentiate it from malignant epidermal tumors.
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Daoudi A, Boutayeb F, Elmrini A. Le pilomatricome isolé du bras : une localisation rare. À propos d'un cas. ACTA ACUST UNITED AC 2006; 25:163-5. [PMID: 17175805 DOI: 10.1016/j.main.2006.07.034] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Pilomatrixoma also known as calcified epithelioma of Malherbe, is a rare benign cutaneous tumor. It is most commonly seen in the head and neck areas, during the first two decades of life. We report a 30-year-old female patient with a rare localisation of pilomatrixoma in the right arm. The pilomatrixoma was excised and at one year follow-up there has been no evidence of recurrence.
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Affiliation(s)
- A Daoudi
- Service de traumato-orthopédie, CHU Hassan-II, Fès, Maroc.
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Abstract
We report a 10-year-old girl with synchronous multiple pilomatrixomas. Pilomatrixomas are generally solitary tumors; synchronous multiple tumors are very rare. Multiple or recurring tumors may be found in association with various syndromes, and multiple tumors may be familial. Concurrent disorders were not identified in our patient and the etiology of her pilomatrixomas was not understood. Thorough examination of the patient and long-term follow-up are necessary with these tumors.
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Affiliation(s)
- Gülden Avci
- Department of Plastic and Reconstructive Surgery Dr. Lütfi Kirdar Kartal Education and Research Hospital Istanbul, Turkey.
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Hwang JY, Lee SW, Lee SM. The common ultrasonographic features of pilomatricoma. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2005; 24:1397-402. [PMID: 16179624 DOI: 10.7863/jum.2005.24.10.1397] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
OBJECTIVES The purpose of this series was to describe typical ultrasonographic features of 20 cases of pilomatricoma and to improve its diagnostic rate with the use of an ultrasonographic approach. METHODS For 20 pilomatricomas in 19 patients with preoperative ultrasonography from 1995 to 2004, we reviewed age, sex, symptoms, duration, referring clinician, and tumor sites. The ultrasonographic findings were retrospectively analyzed for tumor location, shape, size, margin, echo texture, echogenicity, presence, amount, and shape of calcification, presence of a hypoechoic rim, and Doppler flow pattern. RESULTS The mean age of the 19 patients was 6.9 years (range, 1-21 years), and the female-male ratio was 1.1:1. Patients had a painful palpable mass in 10 cases (50%). Nine lesions occurred in the neck, 5 in the cheek, 2 in the preauricular region, and 4 in the extremity. All tumors were located in the subcutaneous layer. The mean size of the tumors was 13.4 mm. Fourteen pilomatricomas (70%) appeared as well-defined oval masses. Tumors were heterogeneously hyperechoic in 80% of cases. All tumors had internal echogenic foci. A hypoechoic rim was seen in 17 cases (85%). Doppler flow signals were observed in the peripheral region in 14 cases (70%). A correct preoperative diagnosis was made in 33% on the basis of clinical findings and in 76% by ultrasonography. CONCLUSIONS Diagnosis of pilomatricoma should be considered when a well-defined mass with inner echogenic foci and a peripheral hypoechoic rim or a completely echogenic mass with strong posterior acoustic shadowing in the subcutaneous layer of the head, neck, or extremity is found on ultrasonography.
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Affiliation(s)
- Ji Young Hwang
- Department of Radiology and Medical Research Institute, Ewha Womans University College of Medicine, 911-1 Mokdong, Yangcheongu, 158-710 Seoul, Korea
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Lemos LB, Brauchle RW. Pilomatrixoma: a diagnostic pitfall in fine-needle aspiration biopsies. A review from a small county hospital. Ann Diagn Pathol 2004; 8:130-6. [PMID: 15185259 DOI: 10.1016/j.anndiagpath.2004.03.004] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
A 10-year-old Hispanic girl presented with a 3-cm mass over her right parotid region. A fine-needle aspiration (FNA) was performed and the preliminary and final diagnoses were "suspicious for carcinoma, possible mucoepidermoid carcinoma." A subsequent computed tomography demonstrated an extra-parotid lesion attached to the skin. The FNA smears were reviewed and the diagnosis of a pilomatrixoma (PMT) was reached. The lesion was excised and the diagnosis of benign PMT confirmed. Pilomatrixomas are uncommon skin adnexal tumors most commonly found in the head and neck area of young adults and children. In 10 years there were 16 PMTs among 60,280 surgical pathology specimens in the pathology files of our 300-bed general county hospital. Pilomatrixoma is recognized as a diagnostic pitfall not only clinically but also on FNA cytology. On the physical examination, the bluish skin discoloration over the lesion so typical of PMT was overlooked. On FNA, the basaloid cells of PMT were mistaken for intermediate cells of mucoepidermoid carcinoma. The presence of anucleated squames was not properly recognized. These are usually absent in mucoepidermoid carcinoma and represent a hallmark of PMT. This case illustrates well the risk of misdiagnosing a pre-auricular PMT as a malignant tumor of the parotid gland.
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Affiliation(s)
- Luciano B Lemos
- Department of Pathology and Surgery (Head and Neck), University of Texas Healthcare Center, Houston Medical School, Lyndon B. Johnson General Hospital, Houston, TX, USA
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Silva TAD, Moraes Júnior EF, Consolaro A, Lara VS. Pilomatricoma of the auricular region: case report. Braz Dent J 2004; 14:223-6. [PMID: 15057402 DOI: 10.1590/s0103-64402003000300016] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Pilomatricomas are relatively rare tumors of ectodermal origin from the outer root sheath cell of the hair follicle. They are usually asymptomatic, solitary, firm or hard, freely mobile, dermal or subcutaneous nodules. The purpose of this article is to present a case that illustrates the diagnostic difficulty encountered by oral surgeons and pathologists and to review the literature regarding pilomatricomas of the auricular region.
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Affiliation(s)
- Tarcília Aparecida da Silva
- Department of Stomatology (Pathology), Faculty of Dentistry of Bauru, University of São Paulo, Bauru, SP, Brazil.
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Fernandes R, Holmes J, Mullenix C. Giant pilomatricoma (epithelioma of Melherbe): report of a case and review of literature. J Oral Maxillofac Surg 2003; 61:634-6. [PMID: 12730846 DOI: 10.1053/joms.2003.50122] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Rui Fernandes
- Department of Oral and Maxillofacial Surgery, University of Alabama at Birmingham School of Medicine, Birmingham, AL, USA
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Sari A, Yavuzer R, Isik I, Latıfoǧlu O, Ataoǧlu Ö. Atypical Presentation of Pilomatricoma: A Case Report. Dermatol Surg 2002. [DOI: 10.1046/j.1524-4725.2002.01315.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Hasson O, Shacham R, Nahlieli O, Saal CJ. A firm, bluish mass of the cheek in a 17-month-old child. J Oral Maxillofac Surg 2002; 60:301-4. [PMID: 11887144 DOI: 10.1053/joms.2002.30587] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Oscar Hasson
- Senior Surgeon, Department of Oral and MaxilloFacial Surgery, Kaplan Medical Center, Rehovot, Israel.
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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. [PMID: 11165649 DOI: 10.1016/s0165-5876(00)00449-3] [Citation(s) in RCA: 68] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To discuss the clinical course and management of pilomatricoma involving the head and neck in the pediatric age group and to review the literature. METHODS Retrospective analysis of the author's case files between the years of 1996 and 2000, revealed seven cases of head and neck pilomatricoma involving children. A literature review was employed to compare this study to others. RESULTS In all cases, the presenting sign was a superficially located rock-hard mass in the head and neck. The mean duration the mass was present at the initial otolaryngologic evaluation was 11 months. There was a total of seven patients of which five (71%) were female while two (29%) were male. Each patient presented with a single pilomatricoma. Five (71%) occurred in the neck while two (29%) occurred in the face. All were treated with surgical excision. There were no recurrences. CONCLUSION Pilomatricoma is a rare, benign, skin neoplasm that is superficially located and most commonly occurs in the head and neck, thus otolaryngologists should be aware of its clinical presentation. Although malignant transformation has been described, it is exceedingly rare. Diagnosis is usually suspected based on palpation of a superficial, rock-hard mass and confirmed by histopathologic examination. Since this neoplasm doesn't spontaneously regress, surgical excision is both curative and the treatment of choice. Recurrence is rare.
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Affiliation(s)
- M W Yencha
- Department of Otolaryngology, Head and Neck Surgery, NH-Pensacola, 6000 West Highway 98, Pensacola, FL 32512, USA.
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