An Unusual Tumor of the Ear: Pilomatricoma in a Middle-Aged Woman

Inagaki, Atsushi; Yamashita, Yoshihisa; Mori, Yusuke; Takeuchi, Erika; Asaoka, Kyosuke; Murakami, Shingo

doi:10.1155/2019/4975216

Cited by 6 publications

(31 citation statements)

References 11 publications

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“…Basaloid and ghost cells were present in the histological sections of 16 cases (100%) that we analyzed, which is in contrast to a previous retrospective study that reported only 13.7% pilomatricomas in all locations presented with both cells [5]. Moreover, such cells were evident in our case, and we found that calcification was present in only ten other cases (62.5%), possibly corresponding to the tendency of this tumor to be excised early, during which calcification has not been evident [11]. Furthermore, in our case, we identified the presence of ossification, another marker of late lesions, which was found in only two other cases (12.5%) of pilomatricoma of the auricle.…”

Section: Discussion/conclusioncontrasting

confidence: 98%

“…One retrospective study has shown that pilomatricoma of the auricle may lead to misdiagnoses because of its close clinical resemblance to other skin conditions such as a dermoid cyst compared with cases involving other body parts [ 6 ]. In addition, given the rarity of its occurrence in the auricle, clinicians may initially consider other differential diagnoses that are commonly found in this area, such as squamous cell carcinoma, or those that almost exclusively occur in the auricle, such as tumors of the ceruminous gland [ 11 ].…”

Section: Discussion/conclusionmentioning

confidence: 99%

“…3 ). Five cases (31.25%) were located in the earlobe [ 10 , 12 , 13 , 14 , 15 ], followed by the helix [ 3 , 16 , 17 , 18 ] (4 cases/25%), outer ear canal [ 19 , 20 , 21 ] (3 cases/18.75%), antihelix anterior [ 22 , 23 ] (2 cases/12.5%), helical root [ 24 ], and cymba conchae [ 11 ] (1 case each/6.25%). None of those cases reported pilomatricoma on the posterior part of the antihelix as in our case.…”

Section: Discussion/conclusionmentioning

confidence: 99%

“…However, none of these cases were correctly diagnosed as pilomatricoma, including our case. The unusual location of pilomatricoma on the auricle may contribute to misdiagnoses [ 11 ]. Of all the cases that we reviewed, pilomatricomas were commonly mistaken as dermoid cysts (3 cases/18.75%), followed by pyogenic granulomas and hemangiomas (2 cases each/12.5%).…”

Section: Discussion/conclusionmentioning

confidence: 99%

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Keloid-like Pilomatricoma of the Auricle: A Case Report and Review of Literature

et al. 2022

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Pilomatricoma is a rare benign skin adnexal tumor arising from hair matrix cells. It usually manifests as a firm-to-hard, well-circumscribed, nontender nodule often mistaken as a dermoid cyst. However, its clinical presentation has been reported to mimic keloid. In addition, although it occurs most frequently in the head and neck area, pilomatricoma is rarely reported on the auricle. Herein, we reported a case of pilomatricoma occurring on the posterior part of a 9-year-old girl’s auricle. Unlike classic pilomatricoma, the tumor closely resembled a keloid. Nevertheless, histological examination following excision of the tumor revealed a dermal tumor arranged in solid nests consisting of basaloid and ghost cells along with foreign body reaction, calcification, and ossification, confirming the diagnosis of pilomatricoma. The rarity, atypical clinical presentation, and unique location of this tumor contributed to the misdiagnosis of this case. Therefore, we reviewed previous cases of pilomatricoma of the auricle reported in the literature to provide a comprehensive understanding of this rare entity.

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Section: Discussion/conclusioncontrasting

confidence: 98%

Section: Discussion/conclusionmentioning

confidence: 99%

Section: Discussion/conclusionmentioning

confidence: 99%

Section: Discussion/conclusionmentioning

confidence: 99%

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Keloid-like Pilomatricoma of the Auricle: A Case Report and Review of Literature

et al. 2022

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“…The atypical features identified include minimal infiltrating margin, focal cytological atypia of the basaloid cells with an increase in mitotic activity, and rare areas of necrosis. Also, in our case, the cellular portion is more predominant than shadow cells, which is an unusual feature for long-standing lesions [ 5 ]. The histological stages of pilomatrixoma are (1) early small cystic lesions, (2) fully developed large cystic lesions, (3) early regressive lesions with foci of basaloid cells and shadow cells with multinucleated giant cells, and (4) late regressive lesions with numerous shadow cells and less basaloid cell foci as well as presence of calcification and ossification [ 6 ].…”

Section: Discussionmentioning

confidence: 86%

Pilomatrixoma with Atypical Features: A Case Report

Missak¹,

Haig²,

Gabril³

2021

Case Rep Dermatol

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Pilomatrixoma is an uncommon, benign tumor with differentiation towards both the hair matrix and cells arising in the cortex, most frequently appearing in the first or second decade of life. In rare instances, pilomatrixomas can show malignant transformation. Pilomatrix carcinoma is extremely uncommon and has traditionally been considered a tumor of low malignant potential; however, a high local recurrence rate has been reported. There is a paucity of literature on these lesions, with only a few reports describing the spectrum of malignant changes seen in these lesions. In this case report, we present a case of pilomatrixoma in an adult patient showing atypical features. While the tumor is small, there are focal features that suggest progression to malignancy, but do not fulfill the criteria for pilomatrix carcinoma. These focal atypical features include a focal infiltrative pattern at the periphery, with a variable cytological atypia and an increased mitotic rate, up to five mitotic events/high-power field. Irregular foci of central necrosis (comedonecrosis) were present in several lobules. Some of the features identified were similar to a subset of pilomatrixoma, known as “proliferating pilomatrixoma.” However, our case did not have the diffuse changes or larger size that has been frequently reported in “proliferating pilomatrixoma.” In conclusion, given the lack of focality of the changes, the lesion in our case is best described as a pilomatricoma with atypical features. Furthermore, our case may highlight the need to ensure close clinical follow-up for these lesions with unexpected atypical features that raise concern of recurrence and malignant transformation.

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Nodular Mass in the Earlobe of an 18-Month-Old Girl

Jeong

Kim

Choi

2021

JAMA Otolaryngol Head Neck Surg

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An 18-month-old girl presented with a 1-year history of a slow-growing mass in the right earlobe. There were no symptoms, such as tenderness or discharge, associated with the mass. She had no history of underlying medical disease or trauma. On physical examination, a 1.5 × 1.0-cm, firm, nodular, angulated, pinkish, nontender mass was observed in the posterior aspect of the right earlobe (Figure , A). The skin over the mass was semitransparent, and the mass moved freely beneath the skin. Under suspicion of a tumorous lesion, complete excision was performed after the patient received general anesthesia. Histopathologic findings were characteristic for 2 cell types; basaloid cells with a nucleus were present in the periphery, and ghost cells without a nucleus were present in the center (Figure , B). Six months after surgery, the wound had healed well, and there has been no recurrence. Diagnosis B. Pilomatricoma DiscussionPilomatricoma is a benign tumor that originates from hair follicle matrix cells. [1][2][3][4][5][6][7] It occurs frequently during the first 2 decades of life, especially in children 10 years or younger, and appears more in females than in males. 1,3,[6][7][8] The head and neck are the most commonly involved regions, particularly the neck and preauricular regions. 1,3,6,8 Pilomatricoma is rare in the auricle. 3,6

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An Unusual Tumor of the Ear: Pilomatricoma in a Middle-Aged Woman

Cited by 6 publications

References 11 publications

Keloid-like Pilomatricoma of the Auricle: A Case Report and Review of Literature

Keloid-like Pilomatricoma of the Auricle: A Case Report and Review of Literature

Pilomatrixoma with Atypical Features: A Case Report

Nodular Mass in the Earlobe of an 18-Month-Old Girl

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