Journal of Cutaneous and Aesthetic Surgery
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CASE REPORT Table of Contents   
Year : 2009  |  Volume : 2  |  Issue : 1  |  Page : 36-37
Pilomatrixoma of earlobe


1 Department of Pediatric Surgery, Hedi Chaker Hospital, Sfax, Tunisia
2 Department of Pathology, Habib Bourguiba Hospital, Sfax, Tunisia

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Date of Web Publication1-Jul-2009
 

   Abstract 

Pilomatrixomas are uncommon in children and are frequently misdiagnosed preoperatively. We report a two-year-old female patient with an unusual localization in the earlobe. The lesion was treated by simple enucleation and in two years of follow-up there has been no evidence of recurrence. The case is being reported in view of its rarity and unusual location.

Keywords: Calcification, earlobes, pilomatrixoma

How to cite this article:
Jallouli M, Yengui H, Khabir A, Mhiri R. Pilomatrixoma of earlobe. J Cutan Aesthet Surg 2009;2:36-7

How to cite this URL:
Jallouli M, Yengui H, Khabir A, Mhiri R. Pilomatrixoma of earlobe. J Cutan Aesthet Surg [serial online] 2009 [cited 2019 Aug 17];2:36-7. Available from: http://www.jcasonline.com/text.asp?2009/2/1/36/53099



   Introduction Top


Pilomatrixomas are uncommon tumors which are frequently misdiagnosed preoperatively. The tumor usually appears in the first two decades of life and is commonly located in the head and neck region. [1],[2] Few cases of pilomatrixoma in the auricular area and earlobe have been reported. [3] We report a case of pilomatrixoma of earlobe.


   Case Report Top


A two-year-old girl presented with a firm swelling in the earlobe of eight months duration. There was history of trauma to the area. Initially, the swelling was red and painful; hence, patient was thought to have an abscess and treated with systemic antibiotics but in vain. Lesion gradually increased in size and there was spontaneous resolution of redness.

Examination of the left earlobe revealed a non-tender, firm, well-circumscribed, freely mobile nodule located below the right ear nodule [Figure 1]. The overlying skin was normal in appearance. The surgical procedure consisted of enucleation of the lesion. At the time of surgery, the tumor was easily shelled out of the surrounding tissues. The surgical specimen revealed a hard irregular mass measuring 1.5 ◊ 1 ◊ 0.5 cm. The histopathologic exam confirmed the diagnosis of pilomatrixoma [Figure 2]a and b. Patient has been followed up for two years with no recurrences and satisfactory cosmetic result [Figure 3].


   Discussion Top


Pilomatrixoma is a relatively rare, benign skin tumor arising from the hair follicle. Pilomatrixoma occurs at any age, but is most common in children under the age of ten. [1] Women [2] and White race [4] are more prone for pilomatrixoma.

Although pilomatrixoma is common in the head and neck region, [1],[2] it can also be found in the scalp, eyelids, arms and preauricular area. [1],[2],[3] It typically presents as a slow-growing, superficial, firm, asymptomatic, freely mobile mass of the dermis. It is usually solitary, but multiple lesions have been reported. [5],[6] Inflammation or hemorrhage into the neoplasm may give rise to sudden increase in size.

Pilomatrixoma develops from an abnormal formation of cells that are similar to hair cells, which become hardened or calcified. The etiology is not completely understood, though the role of activating mutation in the b-catenin gene mapped to Chromosome 3p22-21.3 has been reported. [7],[8] Pilomatrixoma may rarely be familial and such familial cases may be also observed in association with disorders such as Gardner syndrome, Steinert disease, sarcoidosis, myotonic dystrophy, Turner syndrome, xeroderma pigmentosum. [1],[2],[8]

Biopsy is the gold standard for diagnosis of this condition; [7] fine needle aspiration cytology is not adequate and therefore not recommended for diagnostic purpose. [9]

The treatment of choice is local excision. [1],[2] Recurrence after complete surgery is rare, as in our case. Malignant transformation has not been reported in children. [10],[11]


   Conclusion Top


Physicians, otolaryngology's, dermatologists and surgeons should be familiar with this entity of pilomatrixoma and consider it in the differential diagnosis of superficial or calcified subcutaneous masses in the auricular region.

 
   References Top

1.Duflo S, Nicollas R, Roman S, Magalon G, Triglia JM. Pilomatrixoma of the head and neck in children: A study of 38 cases and a review of the literature. Arch Otolaryngol Head Neck Surg 1998;124:1239-42.  Back to cited text no. 1  [PUBMED]  [FULLTEXT]
2.Lan MY, Lan MC, Ho CY, Li WY, Lin CZ. Pilomatrixoma of the head and neck: A retrospective review of 179 cases. Arch Otolaryngol Head Neck Surg 2003;129:1327-30.  Back to cited text no. 2  [PUBMED]  [FULLTEXT]
3.Sevin K, Can Z, Yilmaz S, Saray A, Yormuk E. Pilomatrixoma of the earlobe. Dermatol Surg 1995;21:245-6.  Back to cited text no. 3  [PUBMED]  
4.Thomas RW, Perkins JA, Ruegemer JL, Munaretto JA. Surgical excision of pilomatrimoxoma of the head and neck: A retrospective review of 26 cases. Ear Nose Thorat J 1999;514:544-6.  Back to cited text no. 4    
5.Aslan G, Erdoπan B, Akφz T, GφrgŁ M, Seηkin S, Terzioπlu A. A Multiple occurrence of pilomatrixoma. Plast Recconstr Surg 1996;98:510-3.  Back to cited text no. 5    
6.Urvoy M, Legall F, Toulemont PJ, Chevrant-Breton J. Multiple pilomatricoma. Apropos of a case. J Fr Ophtalmol 1996;19:464-466.  Back to cited text no. 6    
7.Kajino Y, Yamaguchi A, Hashimoto N, Matsuura A, Sato N, Kikuchi K. Beta-Catenin gene mutation in human hair follicle-related tumors. Pathol Int 2001;51:543-8.  Back to cited text no. 7  [PUBMED]  [FULLTEXT]
8.Nassie DI, Volkov A, Kronenberg J, Talmi YP. Pilomatrixoma of the ear helix. Imaj 2007;9:763-4.  Back to cited text no. 8  [PUBMED]  [FULLTEXT]
9.Danielson-Cohen A, Lin SJ, Hughes CA, An YH, Maddalozzo J. Head and neck pilomatrixoma in children. Arch Otolaryngol Head Neck Surg 2001;127:1481-3.  Back to cited text no. 9    
10.Vinayak BC, Cox GJ, Ashton-Key M. Pilomatrixoma of the external auditory meatus. J Laryngol Otol 1993;107:333-4.  Back to cited text no. 10  [PUBMED]  
11.Lineaweaver WC, Wang TN, Leboit PL. Pilomatrix carcinoma. J Surg Oncol 1988;37:171-4.  Back to cited text no. 11  [PUBMED]  

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Correspondence Address:
Mohamed Jallouli
Department of Pediatric Surgery, Hedi Chaker Hospital. 3029, Sfax
Tunisia
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0974-2077.53099

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    Figures

  [Figure 1], [Figure 2], [Figure 3]



 

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    Abstract
    Introduction
    Case Report
    Discussion
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    References
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