Pilomatrixoma is considered a rare benign tumor arising from the hair follicle, most common in the head and neck region, but it is rarely diagnosed on a clinical basis. This report describes a new case of giant pilomatrixoma in a 36-year-old female patient. The nodule was localized in the preauricular area on the right side, appearing as a slow-growing, fixed, painless, with a hardened consistency, unusual giant (4.5 cm). A cone-beam computed tomography (CBCT) examination showed a slightly hyperdense lesion, and fine-needle aspiration cytology (FNAC) revealed peripheral blood and mononucleated inflammatory cells. After enucleation of lesion, a diagnosis of pilomatrixoma was confirmed. The differential diagnosis of pilomatrixoma is broad, because its characteristics also can be found in other lesions common to the head and neck. Thus, a lesion in the head and neck, adherent to the skin, and well demarcated, mainly in the young and in females, should be suspected as pilomatrixoma.
Pilomatrixoma Pilomatricoma Calcifying epithelioma of Malherbe Head and neck Skin
This is a preview of subscription content, log in to check access.
Special thanks to Professor Brad Neville for the English stile review and advise during the diagnostic process.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
The consent of patient was obtained for publication of this case report and images.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Lee KH, Kim HJ, Suh CH (2000) Pilomatricoma in the head and neck: CT findings in three patients. J Comput Assist Tomogr 24:332–335CrossRefGoogle Scholar
Sinhasan SP, Jadhav CR, Bhat RV, Amaranathan A (2013) Pilomatrixoma - presented as hypopigmented tender nodule: diagnosed by FNAC: a case report with review of literature. Indian J Dermatol 58:405CrossRefGoogle Scholar
Zloto O, Fabian ID, Vishnevskia Dai V, Ben Simon GJ, Rosner M (2015) Periocular pilomatrixoma: a retrospective analysis of 16 cases. Ophthal Plast Reconstr Surg 31:19–22CrossRefGoogle Scholar
Makek M, Franklin DJ, Fisch U (1989) Preauricular pilomatrixoma: a diagnostic pitfall. Oral Surg Oral Med Oral Pathol 68:451–454CrossRefGoogle Scholar
Malherbe A, Chenantais J (1880) Note surl’epitheliome calcifit: desglandes sebaces. Progr Med 8:826–828Google Scholar
De Rosa DC, Lin-Hurtubise K (2012) Pilomatricoma: an un usual dermatologic neoplasm. Hawaii J Med Public Health 71:282–286Google Scholar
Lever WF, Griesemer RD (1949) Calcifying epithelioma of Malherbe; report of 15 cases, with comments on its differentiation from calcified epidermal cyst and on its histogenesis. Arch Dermatol Syphilol 59:506–518CrossRefGoogle Scholar
Souto MP, Matsushita MM, Matsushita GM, Souto LR (2013) An unusual presentation of giant pilomatrixoma in an adult patient. J Dermatol Case Rep 7:56–59CrossRefGoogle Scholar
Whittemore KR, Cohen M (2012) Imaging and review of a large pre-auricular pilomatrixoma in a child. World J Radiol 4:228–230CrossRefGoogle Scholar
Cappellesso R, Bellan A, Saraggi D, Salmaso R, Ventura L, Fassina A (2015) YAP immunoreactivity is directly related to pilomatrixoma size and proliferation rate. Arch Dermatol Res 307:379–383CrossRefGoogle Scholar
Rachakonda T, Kacker A, Koizumi J (2010) Pediatric pilomatrixoma of the preauricular region. Acta Cytol 54:724–726CrossRefGoogle Scholar
Yoshimura Y, Obara S, Mikami T, Matsuda S (1997) Calcifying epithelioma (pilomatrixoma) of the head and neck: analysis of 37 cases. Br J Oral Maxillofac Surg 35:429–432CrossRefGoogle Scholar
Williams CM, Bozner P, Oliveri CV, Horenstein MG (2003) Melanocytic matricoma: case confirmation of a recently described entity. J Cutan Pathol 30:275–278CrossRefGoogle Scholar
Vidyalakshmi S, Aravindhan R (2014) Adenoid cystic carcinoma of the buccal mucosa: a case report with review of literature. J Clin Diagn Res 8:266–268Google Scholar
Aydin S, Bilmez ZE, Erdogdu S, Altintoprak N, Kayipmaz S (2016) Complicate giant pilomatrixoma of the parotid region. J Maxillofac Oral Surg 15:111–115CrossRefGoogle Scholar
Sciandra D, Dispenza F, Porcasi R, Kulamarva G, Saraniti C (2008) Pleomorphic adenoma of the lateral nasal wall: case report. Acta Otorhinolaryngol Ital 28:150–153PubMedPubMedCentralGoogle Scholar
Vicente OP, Marqués NA, Aytés LB, Gay Escoda C (2008) Minor salivary gland tumors: a clinicopathological study of 18 cases. Med Oral Patol Oral Cir Bucal 13:E582–E588Google Scholar
Just T, Hingst V, Kreutzer HJ, Pau HW (2005) Hard, expanding preauricular swelling in a 6-year-old child. HNO 53:1074–1076CrossRefGoogle Scholar
Bernier FE, Schreiber A, Coulombe J, Hatami A, Marcoux D (2017) Pilomatricoma associated with kabuki syndrome. Pediatr Dermatol 34:e26–e27CrossRefGoogle Scholar
Bajpai M, Arora M, Chandolia B (2016) A rare case of pilomatrixoma (calcifying epithelioma of Malherbe) of parotid space masquerading as salivary gland tumor. Iran J Pathol 11:418–420PubMedPubMedCentralGoogle Scholar
Dutta M, Chatterjee I (2016) A lesson learnt: retrospection in a case of pilomatricoma mimicking as parotid neoplasm. Einstein (Sao Paulo) 14:104–105CrossRefGoogle Scholar
Bellafiore S, Tagliavini E, Carlinfante G, Piana S (2016) Pilomatrixoma is a diagnostic trap in fine-needle aspiration cytology of the parotid region. Diagn Cytopathol 44:516–518CrossRefGoogle Scholar
Bhatt MK, Sommerville R, Ravi Kumar AS (2012) FDG PET/CT appearance of benign pilomatricoma. Clin Nucl Med 37:684–686CrossRefGoogle Scholar
Hwang JY, Lee SW, Lee SM (2005) The common ultrasonographic features of pilomatricoma. J Ultrasound Med 24:1397–1402CrossRefGoogle Scholar
Yuca K, Kutluhan A, Cankaya H, Akman E (2004) Giant pilomatrixoma arising in the preauricular region: a case report. Kulak Burun Bogaz Ihtis Derg 12:147–149PubMedGoogle Scholar
Silva TA, Moraes EF Jr, Consolaro A, Lara VS (2003) Pilomatricoma of the auricular region: case report. Braz Dent J 14:223–226CrossRefGoogle Scholar
Sari A, Yavuzer R, Isik I, Latifoglu O, Ataoglu O (2002) Atypical presentation of pilomatricoma: a case report. Dermatol Surg 28:603–605PubMedGoogle Scholar
Phyu KK, Bradley PJ (2001) Pilomatrixoma in the parotid region. Laryngol Otol 115:1026–1028Google Scholar
Ooi LL, Sim CS, Soo KC (1992) Calcifying epithelioma of Malherbe--a case report of a large preauricular tumour. Ann Acad Med Singap 21:379–381PubMedGoogle Scholar
Yoshimura Y, Oka M (1990) Pilomatrixoma of the preauricular region. Br J Oral Maxillofac Surg 28:416–418CrossRefGoogle Scholar
Cianga CM, Cianga P, Dumitrescu GF, Sava A (2016) IL-8, IL-8RA (CXCR1) and IL-8RB (CXCR2) expression in pilomatricoma. Romanian J Morphol Embryol 57:59–64Google Scholar