Pilomatricoma of the Head and Neck

OBJECTIVE: To describe the clinical presentations and management of pilomatricoma, formerly known as pilomatrixoma, of the head and neck. DESIGN: Retrospective study. SETTING: Tertiary care center. PATIENTS: The study included 179 patients with a diagnosis of pilomatricoma of the head and neck. INTERVENTION: All patients underwent surgical excision for pilomatricoma of the head and neck between 1991 and 2002. RESULTS: Pilomatricoma occurred at any age (mean age, 29.8 years); 45.3% of the cases occurred in patients younger than 18 years. The female-male ratio was 0.97:1. The average size of the lesion was 1 cm. The most common sites of occurrence were the neck (30.2%), cheeks (16.8%), scalp (16.2%), and brow and periorbital area (14.0%). Multiple occurrence was found in 1 case. Two of 179 tumors recurred after surgical excision. CONCLUSIONS: Because preoperative diagnosis of pilomatricoma is usually incorrect, careful clinical examination and a high index of suspicion would result in a more accurate diagnosis. Complete surgical excision is the treatment of choice. Otolaryngologists should consider pilomatricoma in the differential diagnosis of neck masses.