This 10 year-old boy presented with a slowly-growing, hard tumor of the left parotid region.
The mass was approached via a standard parotidectomy incision. The tumor was well encapsulated. and separated easily from surrounding skin and parotid tissue. The histologic diagnosis was pilomatrixoma (pilomatricoma).
Pilomatrixoma, or calcifying epithelioma of Malherbe, is an uncommon, benign, epithelial tumor of the skin that often arises in head and neck regions, in the first 2 decades of life. In 88% of cases, the presenting symptom was a hard, slow-growing, subcutaneous tumor. The lesion was associated with pain and inflammation in 7 cases (18%) and abscess or ulceration in 4 cases (11%). Twenty-nine patients presented with single nodules and 4 presented with multiple occurrences. The lesions were located on the face (cheek, eyelid, or forehead) in 20 cases (53%), on the neck in 8 cases (21%), in the parotid region in 8 cases (21%), and on the scalp in 2 cases (5%).
Diagnosis is usually easy based on clinical findings, but computed tomographic scan is helpful, especially in cases involving tumors located in the parotid region. Spontaneous regression is never observed. Complete surgical excision is the treatment of choice.
Pilomatrixoma of the Head and Neck in Children, A Study of 38 Cases and a Review of the Literature .Suzy Duflo, MD; Richard Nicollas, MD; Stéphane Roman, MD; Guy Magalon, MD; Jean Michel Triglia, MD . Arch Otolaryngol Head Neck Surg. 1998;124:1239-1242.