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Pediatric Radiology

, Volume 37, Issue 6, pp 549–555 | Cite as

Pilomatricomas in children: imaging characteristics with pathologic correlation

  • Hyun Wook Lim
  • Soo Ah ImEmail author
  • Gye-Yeon Lim
  • Hyun Jin Park
  • Heejeong Lee
  • Mi Sook Sung
  • Bong Joo Kang
  • Jee Young Kim
Original Article

Abstract

Background

Although pilomatricoma commonly occurs in children, there is still a poor understanding of the imaging characteristics of pilomatricoma and lack of agreement regarding its imaging findings and histopathologic features.

Objectives

To characterize the radiologic appearance of pilomatricomas on US, CT, and MR and to correlate the imaging findings with histopathologic features.

Materials and methods

The imaging findings of 47 pilomatricomas on US (n = 17), CT (n = 31), and MR (n = 5) were retrospectively evaluated. Pathologic specimens of all cases were reviewed and compared with imaging findings.

Results

All lesions were well-circumscribed, subcutaneous nodules with partial attachment to the overlying skin. On US, the lesions were mostly hyperechoic with posterior acoustic shadowing and hypoechoic rim. On CT, they appeared as enhancing soft-tissue masses with varying amounts of calcification. MR findings were internal reticulations and patchy areas on T2-weighted images and contrast-enhanced T1-weighted images, corresponding to edematous stroma on pathology. Peritumoral inflammatory changes and connective capsule on pathology were well correlated with imaging findings.

Conclusion

Pilomatricoma should be considered when US or CT shows a well-defined hyperechoic or calcific nodule in subcutaneous fat attached to the skin in children. MR images may be helpful in diagnosis. Pathologic findings are well correlated with imaging findings.

Keywords

Pilomatricoma US CT MRI Children 

Notes

Acknowledgements

We thank Bonnie Hami, MA, Department of Radiology, University Hospitals Health System, Cleveland, Ohio, for her editorial assistance in preparing the manuscript.

References

  1. 1.
    Malherbe A, Chenantais J (1880) Note sur l’epitheliome calcifie des glandes sebacees. Prog Med 8:826–828Google Scholar
  2. 2.
    Kaddu S, Soyer HP, Cerroni L et al (1994) Clinical and histopathologic spectrum of pilomatricomas in adults. Int J Dermatol 33:705–708PubMedCrossRefGoogle Scholar
  3. 3.
    Forbis R Jr, Helwig EB (1961) Pilomatrixoma (calcifying epithelioma). Arch Dermatol 83:606–618PubMedGoogle Scholar
  4. 4.
    Moehlenbeck FW (1973) Pilomatrixoma (calcifying epithelioma): a statistical study. Arch Dermatol 108:532–534PubMedCrossRefGoogle Scholar
  5. 5.
    Knight PJ, Reiner CB (1983) Superficial lumps in children: what, when, and why? Pediatrics 72:147–153PubMedGoogle Scholar
  6. 6.
    Lan MY, Lan MC, Ho CY et al (2003) Pilomatricoma of the head and neck: a retrospective review of 179 cases. Arch Otolaryngol Head Neck Surg 129:1327–1330PubMedCrossRefGoogle Scholar
  7. 7.
    Pirouzmanesh A, Reinisch JF, Gonzalez-Gomez I et al (2003) Pilomatrixoma: a review of 346 cases. Plast Reconstr Surg 112:1784–1789PubMedCrossRefGoogle Scholar
  8. 8.
    Yencha MW (2001) Head and neck pilomatricoma in the pediatric age group: a retrospective study and literature review. Int J Pediatr Otorhinolaryngol 57:123–128PubMedCrossRefGoogle Scholar
  9. 9.
    Masih S, Sorenson SM, Gentili A et al (2000) Atypical adult non-calcified pilomatricoma. Skeletal Radiol 29:54–56PubMedCrossRefGoogle Scholar
  10. 10.
    Hughes J, Lam A, Rogers M (1999) Use of ultrasonography in the diagnosis of childhood pilomatrixoma. Pediatr Dermatol 16:341–344PubMedCrossRefGoogle Scholar
  11. 11.
    Ulrich J, Wesarg I (2001) High-frequency ultrasound in the diagnosis of pilomatrixoma. Pediatr Dermatol 18:163PubMedCrossRefGoogle Scholar
  12. 12.
    Hwang JY, Lee SW, Lee SM (2005) The common ultrasonographic features of pilomatricoma. J Ultrasound Med 24:1397–1402PubMedGoogle Scholar
  13. 13.
    Som PM, Shugar JM, Silvers AR (1998) CT of pilomatrixoma in the cheek. AJNR 19:1219–1220PubMedGoogle Scholar
  14. 14.
    Lee KH, Kim HJ, Suh CH (2000) Pilomatricoma in the head and neck: CT findings in three patients. J Comput Assist Tomogr 24:332–335PubMedCrossRefGoogle Scholar
  15. 15.
    De Beuckeleer LH, De Schepper AM, Neetens I (1996) Magnetic resonance imaging of pilomatricoma. Eur Radiol 6:72–75PubMedCrossRefGoogle Scholar
  16. 16.
    Ichikawa T, Nakajima Y, Fujimoto H et al (1997) Giant calcifying epithelioma of Malherbe (pilomatrixoma): imaging features. Skeletal Radiol 26:602–605PubMedCrossRefGoogle Scholar
  17. 17.
    Hoffmann V, Roeren T, Moller P et al (1998) MR imaging of a pilomatrixoma. Pediatr Radiol 28:272PubMedCrossRefGoogle Scholar
  18. 18.
    Sassmannshausen J, Chaffins M (2001) Pilomatrix carcinoma: a report of a case arising from a previously excised pilomatrixoma and a review of the literature. J Am Acad Dermatol 44:358–361PubMedCrossRefGoogle Scholar
  19. 19.
    Fujioka M, Gozo N, Osamu M et al (2003) Secondary anetoderma overlying pilomatrixomas. Dermatology 207:316–318PubMedCrossRefGoogle Scholar
  20. 20.
    Shames BS, Nassif A, Bailey CS et al (1994) Secondary anetoderma involving a pilomatricoma. Am J Dermatopathol 16:557–560PubMedCrossRefGoogle Scholar
  21. 21.
    Moulin G, Bouchet B, Dos Santos G (1978) Anetodermic cutaneous changes above Malherbe’s tumors. Ann Dermatol Venereol 105:43–47PubMedGoogle Scholar
  22. 22.
    Kransdorf MJ, Meis-Kindblom JM (1994) Dermatofibrosarcoma protuberans: radiologic appearance. AJR 163:391–394PubMedGoogle Scholar
  23. 23.
    Kransdorf MJ, Murphery MD, Temple HT (1998) Subcutaneous granuloma annulare: radiologic appearance. Skeletal Radiol 27:266–270PubMedCrossRefGoogle Scholar
  24. 24.
    Vandevenne JE, Colpaert CG, De Schepper AM (1998) Subcutaneous granuloma annulare: MR imaging and literature review. Eur Radiol 8:1363–1365PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2007

Authors and Affiliations

  • Hyun Wook Lim
    • 1
  • Soo Ah Im
    • 1
    Email author
  • Gye-Yeon Lim
    • 1
  • Hyun Jin Park
    • 1
  • Heejeong Lee
    • 1
  • Mi Sook Sung
    • 1
  • Bong Joo Kang
    • 1
  • Jee Young Kim
    • 1
  1. 1.Department of Radiology, Kangnam St. Mary’s HospitalThe Catholic University of KoreaSeoulSouth Korea

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