Cases reported "Pilomatrixoma"

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1/20. Surgical excision of pilomatrixoma of the head and neck: a retrospective review of 26 cases.

    The objective of this article is to describe our experiences in treating patients for head and neck pilomatrixoma at our institution during a 5-year period and to compare our findings with previously published results. To that end, we conducted a 5-year retrospective chart review to identify those patients who had a confirmed histopathologic diagnosis of pilomatrixoma involving the head and neck area. We reviewed medical records for presenting signs and symptoms, lesion characteristics, treatment rendered, and outcomes. We identified 26 patients, aged 6 to 77 (mean: 33), who met the criteria for inclusion in our study. All had been treated for solitary tumors with simple surgical excision and closure. We found no reported adverse outcomes and no tumor recurrences at the surgical sites. These findings support the use of simple surgical excision as the treatment of choice for these tumors.
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2/20. Unusual multiple pilomatrixomata: case report and review of the literature.

    Pilomatrixomata are rare, benign, calcifying cutaneous tumours of the hair matrix cells. They usually present in childhood with a pre-surgical diagnosis of sebaceous cyst, because of their size and appearance. The usual sites of occurrence are the scalp, head and neck. Treatment is usually surgical excision. We report a case of unusual, multiple, benign pilomatrixomata in an Indian adult. The plastic surgeon should be aware of the various guises of pilomatrixoma and be alert to the important, although rare, occurrence of malignancy.
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3/20. Pilomatricoma in the head and neck: CT findings in three patients.

    We report three cases of pilomatricoma, one in the infrahyoid neck and the others in the preauricular area. In all cases, CT showed well marginated soft tissue masses that were located mainly in the subcutaneous fat, partly attaching to the overlying skin. There was no evidence of infiltration to deeper structures. Substantial amounts of calcification were found in one tumor. Pilomatricoma should be included in diagnostic consideration when CT shows a well marginated subcutaneous soft tissue mass adherent to the skin with or without visible calcification in the head and neck region.
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4/20. pilomatrixoma in the parotid region.

    pilomatrixoma is a benign neoplasm of the hair follicle that may present to the otolaryngologist as a palpable swelling in the head and neck area. The correct diagnosis may be difficult to confirm when it presents in the region of the parotid. The use of fine needle aspiration cytology (FNAC) and diagnostic imaging may help confirm the diagnosis. The correct treatment is surgical. However, should the tumour recur then the possibility of malignancy should be considered.
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5/20. Eyelid pilomatricomas in young adults: a report of 8 cases.

    Pilomatricomas are common benign childhood tumors, which usually occur in the head and neck region. We present 8 patients and review the clinical and histopathologic features of pilomatricoma of the eyelids and eyebrows in young adults. From 1992 to 2000, diagnosis of eyelid pilomatricoma was performed in 8 young adults (13-36 years). The female-male ratio was 3:1. The mean age at presentation was 22 years. Each of our 8 patients had a single tumor, 4 on the upper eyelid and 4 on the eyebrow. Ossification existed in 4 cases. No tumor recurrence has been noted at 3.9 years. Pilomatricomas are uncommon tumors on the eyelid and brow region of young adults. These lesions are frequently misdiagnosed when evaluation is based on clinical evidence alone: only 4 of our cases were correctly diagnosed prior to excisional biopsy.
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6/20. Guess what! Multiple pilomatricomas and Steiner disease.

    An 18-year-old male adolescent was referred to our department for the presence of multiple skin nodules since the age of 9 years. At the age of 22 months the patient was diagnosed as having myotonic dystrophy (Steinert's disease). So far, nine lesions like these have been excised and histologically analysed, two located on the left arm, one on the neck and one on the scalp. A skin examination revealed three nodular lesions, two localised on the scalp (Fig. 1) and one on the trunk (Fig. 2); the lesions ranged from 0.5 to 3.5 cm, and were hard on palpation and asymptomatic, with elevated, smooth and teleangiectatic borders and a central invagination filled with whitish, firm, granular material. The lesions were all excised. The histological examination of all the biopsy specimens revealed basophilic cells at the periphery, and islets of shadow cells with an unstained central area at the site of lost nucleus (Fig. 3). The shadow cells were surrounded by a granulomatous infiltration composed mainly of giant cells.
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7/20. Pilomatricoma--a reprospective analysis of 18 cases.

    Pilomatricoma (calcifying epithelioma of Malherebe) is an uncommon skin tumour that occurs predominantly in young people. No studies are available from the Indian subcontinent on pilomatricoma. We analyzed records of 18 cases of pilomatricoma seen during 5 years period (1995-99). There were 16 females and 2 males and their age ranged from 5 to 60 years. All patients had solitary lesions in 10 out of 18 cases (55.5%), the tumour was located in head and neck region including 5 cases (27%) where it involved orbital margin and eye-brow. In only 2 out of 18 cases, a clinical diagnosis of pilomatricoma was suggested. In addition to the secondary changes described in previous studies, we observed additional changes like myxoid change, oedema fluid and necrosis with karyorrhectic debris in few of these tumours. Making a clinical diagnosis of pilomatricoma can be difficult. The final confirmation is by histopathological examination only.
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8/20. Atypical presentation of pilomatricoma: a case report.

    BACKGROUND: Malherbe tumors, also known as pilomatricomas, are benign cutaneous tumors of hair matrix origin. OBJECTIVE: To discuss a rare case of multiple pilomatricoma of the head and neck region in a very young patient. methods: A 14-month-old baby presented with two lesions, one appearing on the preauricular region and the other on the nasolabial fold. One of the lesions showed significant ulceration. RESULTS: Excisional biopsy was performed for both of the lesions. Although the histopathologic examination suggested pilomatricoma as the diagnosis, the lesion with ulcerations exhibited increased mitosis which made us consider pilomatrix carcinoma in its differential diagnosis. CONCLUSION: Increased mitoses, an uncommon unexpected feature for pilomatricoma, can be a marker for more aggressive biologic behavior.
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9/20. pilomatrixoma of the retroauricular area and arm.

    pilomatrixoma is a benign tumor of hair follicles that usually occurs as a single tumor and appears in the head and neck region, extremities, and trunk. The authors present a case of pilomatrixoma with multifocal localization. Simple excision of lesions is the recommended procedure, and recurrence usually is rare.
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10/20. pilomatrixoma: a diagnostic pitfall in fine-needle aspiration biopsies. A review from a small county hospital.

    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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