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Abstract
Purpose
Four patients who presented with an upper lid mass were diagnosed with pilomatricoma after excisional biopsy. We report the cases to improve the differential diagnoses of upper lid masses through investigation of the clinical manifestations and radiological findings of pilomatricoma.
Case summary
Three females and one male with ages of six, seven, eight and 46 years, respectively, each presented with a slowly growing and painless upper lid mass of a three-month duration. In the six-year-old patient who had a history of trauma related to the mass, the mass was fixed to the skin, although the masses were movable in the other patients. Upon computed tomography (CT), well-circumscribed, enhancing nodules were found. Excisional biopsy was performed for definite diagnosis and treatment. All completely excised masses were hard and encapsulated with a thin membrane. The sizes of the masses were 12 mm, 10 mm, 10 mm, and 7 mm. Histopathologic examination with hematoxylin-eosin staining confirmed the masses to be pilomatricoma. There was no evidence of recurrence at 16, 2, 19, and 21 months after mass excision.
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Figure 1.
Facial photographs show a mass in the upper eyelid (arrow). (A) Eyelid mass in the 6-year-old girl (case 1). (B) Eyelid mass in the 7-year-old boy (case 2). (C) Bluish skin-colored mass of the upper eyelid in the 8-year-old girl (case 3). (D) Movable eyelid mass in the 46-year-old woman (case 4).
Figure 2.
Axial view of the orbit CT. (A) 12 mm-sized well circumscribed nodule with peripheral enhancement (arrow, case 1). (B) 7mm-sized well circumscribed, enhancing nodule in the subcutaneous fat layer (arrow, case 4).
Figure 4.
Histologic findings of mass of all cases are consistent with pilomatricoma. Irregular nets of phantom cells (arrow) with a calcification (asterisk) is shown. Among them, multinucleated giant cells with chronic inflammatory infiltrates (arrow head) are also seen (Hematoxylin-eosin staining, A; ×400, B; ×100).
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