Complicated Giant Pilomatrixoma of the Parotid Region

Abstract

Objective Pilomatrixoma (calcifying epithelioma of Malherbe) is a benign soft tissue tumour arising from dermis or subcutaneous tissue which should be considered in differential diagnosis of preauricular lesions especially when skin fixation is present. Case Report Twenty-three year old male referred to our clinic with complaint of left preauricular swelling over 18 months which enlarged and became painful in the last 2 months. Because the lesion showed signs of infection, surgery was planned after medical therapy was completed. FNAB suggest pleomorphic adenoma as preliminary diagnosis. US or MRI showed no specific feature. Treatment and Prognosis Total excision, superficial parotidectomy with facial nerve sparing was performed after regression of infectious signs. Postoperatively no recurrence was detected. Conclusion Pilomatrixomas are benign tumours but have diagnostic difficulties according to clinical and cytologic findings. This rare lesion should be kept in mind to avoid misdiagnosis as malign parotid tumours, particularly in the presence of skin change.

Multiple and giant perforating pilomatrixoma: a case report

“…Up to 40% of pilomatrixomas arise before the age of 10 years and more than 60% of cases in the first two decades [6,8,9]. Most studies report a slight preponderance in females [1,4,7] and it seems that this tumor occurs usually in Caucasians when compared with Asians and African-Americans [4,8].…”

“…Clinically, pilomatrixomas present as solitary, firm to hard, painless, dermal or subcutaneous nodules ranging from 0,5 to 3 cm; although pilomatrixomas over 10 cm in diameter have rarely been reported in literature [1,4,10]. Multiple or recurring pilomatrixomas are rarely seen and can be associated with myotonic dystrophy, Gardner syndrome, Turner syndrome, trisomy 9, spina bifida or sarcoidosis [6].…”

“…Multiple or recurring pilomatrixomas are rarely seen and can be associated with myotonic dystrophy, Gardner syndrome, Turner syndrome, trisomy 9, spina bifida or sarcoidosis [6]. The overlying skin may be normal or have a reddish or bluish hue in 24% of cases [1,3,8]. The diagnosis may be reached by physical examination, imaging and cytology; however, there is a large number of misdiagnosis [1,3,6].…”

“…It's a relatively rare condition [1] which is frequently misdiagnosed clinically and the correct diagnosis is only histological [1,2]. This tumor presents as a solitary asymptomatic, firm, and skin-colored faint blue/red nodule in the deep dermis and subcutaneous tissue, with an average size of 0.5 to 3.0 cm [3].…”

“…Pilomatrixoma is most commonly seen on the head and neck region followed by the upper extremities [5]. Although it can be seen in all ages and sexes; it is most often encountered in first two decades of life and females [1,[4][5][6][7][8][9].…”