Journal of Cutaneous and Aesthetic Surgery

CASE REPORT
Year
: 2009  |  Volume : 2  |  Issue : 1  |  Page : 36--37

Pilomatrixoma of earlobe


Mohamed Jallouli1, Houssem Yengui1, Abdelmajid Khabir2, Riadh Mhiri1,  
1 Department of Pediatric Surgery, Hedi Chaker Hospital, Sfax, Tunisia
2 Department of Pathology, Habib Bourguiba Hospital, Sfax, Tunisia

Correspondence Address:
Mohamed Jallouli
Department of Pediatric Surgery, Hedi Chaker Hospital. 3029, Sfax
Tunisia

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.



How to cite this article:
Jallouli M, Yengui H, Khabir A, Mhiri R. Pilomatrixoma of earlobe.J Cutan Aesthet Surg 2009;2:36-37


How to cite this URL:
Jallouli M, Yengui H, Khabir A, Mhiri R. Pilomatrixoma of earlobe. J Cutan Aesthet Surg [serial online] 2009 [cited 2020 Jun 1 ];2:36-37
Available from: http://www.jcasonline.com/text.asp?2009/2/1/36/53099


Full Text

 Introduction



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



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



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



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.

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