PILOMATRICOMA OF THE NECK IN EARLY CHILDHOOD: A CASE REPORT

Abstract

Pilomatricoma is a benign adnexal tumor arising from the hair follicle matrix, most commonly encountered in children. While typically presenting as a small superficial lesion, atypical forms in the cervical region may mimic malignant conditions and lead to diagnostic uncertainty. Case Presentation: We report the case of a 3-year-old child with a family history notable for the death of a sibling from lymphoma, who presented with a progressively enlarging posterior cervical mass. Clinical examination revealed a firm, partially hard, painless swelling without signs of inflammation. Given the clinical context, a malignant etiology was initially suspected. Cervical computed tomography (CT) demonstrated a well-defined subcutaneous mass with heterogeneous density and internal calcifications. To further characterize the lesion, cervical magnetic resonance imaging (MRI) was performed, confirming a well-circumscribed lesion without deep tissue invasion. The patient subsequently underwent complete surgical excision with a bloc resection of the mass. Histopathological examination established the diagnosis of pilomatricoma, revealing characteristic basaloid cells, ghost cells, and areas of calcification. Discussion: Pilomatricoma can present as a diagnostic challenge, particularly when located in the cervical region and associated with atypical features or an alarming clinical history. Imaging plays a key role, with calcifications on CT being a helpful clue, while MRI assists in assessing local extension. However, definitive diagnosis relies on histopathological examination. Awareness of this entity is crucial to avoid misdiagnosis and overly aggressive management. Conclusion: Pilomatricoma should be considered in the differential diagnosis of firm cervical masses in children, even in clinically concerning contexts. Complete surgical excision remains both diagnostic and curative.