Evaluation of Ultrasonography and CT for Imaging of Head and Neck Pilomatricoma in Children and Adolescents

Abstract

Background and Objectives Pilomatricoma is a frequently diagnosed skin lesion of the head and neck that may often be misdiagnosed as other skin lesions. This study evaluated whether ultrasonography (USG) or computed tomography (CT) is the most helpful imaging modality for the accurate preoperative diagnosis of pilomatricoma in head and neck regions of children and adolescents.Subjects and Method A retrospective review was conducted for 59 patients with pilomatricoma under the age of 19 years. All cases were pathologically confirmed with pilomatricoma in the head or neck.Results Preoperative imaging examinations were performed with USG in six cases and with CT in nine cases. The accuracy of preoperative diagnosis was compared between three groups: 1) with clinical findings only, 2) with USG, and 3) with CT. The correct preoperative diagnosis was made in 18 (30.5%) of the total of 59 cases. Using only clinical findings, 10 (22.7%) out of 44 patients were diagnosed as pilomatricoma. With the addition of USG, pilomatricoma was diagnosed in 1 (16.7%) out of six cases, whereas with the addition of CT, 7 (77.8%) out of 9 cases (77.8%) were diagnosed correctly. Preoperative diagnosis of pilomatricoma with CT imaging was more accurate than clinical findings only (vs. CT; odds ratio [OR]=11.900, 95% confidence interval [CI] 2.126-66.615; p=0.001) or USG (vs. CT; OR=17.500, 95% CI 1.223-250.357; p=0.020).Conclusion In the preoperative diagnosis of pilomatricoma, imaging modalities such as CT and USG are helpful, with CT offering higher diagnostic accuracy and USG procedural benefits in younger children.

Pilomatricoma Located at the Identical Position in the Right Upper Limb of the Twins: A Rare Case Report

“…Pilomatricoma should be differentially diagnosed from dermoid or epidermoid cysts, dermoid cysts, foreign body granuloma, basal cell carcinoma, calcified lymphadenopathy, ossified or calcified hematomas, giant-cell tumor, lipoma, and trichoblastoma. 5,21 Ultrasonography and computed tomography are frequently employed in the differential diagnosis of pilomatricoma, suggestive of heterogeneity, welldefined ovoid margin, hyperechogenicity or isoechoic heterogeneity, peripheral hypoechoic rim, posterior acoustic shadowing, well-marginated subcutaneous mass, adherent to the overlying skin, and variable amounts of 22 Epidermoid cysts, the most prevalent type of cutaneous cysts, can be challenging to distinguish from pilomatricoma, which showed a round to oval structure, well-circumscribed, vascular mass located in subcutaneous tissue along with phenomena of dorsal acoustic amplification and lateral shadowing in the ultrasound images. 23 Cutaneous hemangiomas were ruled out considering the propensity to infants and the characterization of abundant colored blood flow.…”

Üst Ekstremite Yerleşimli Pilomatrikoma: Olgu Sunumu

“…It can demonstrate the degree of calcification, position and the continuity of the lesion deeper structures. There are also articles in which CT an MRI are used in the diagnosis phase (15,16).…”