Anish Abrol*, Matthew M Smith and Alvin B Ko
Abstract:
A 55-year-old Hispanic woman presented with a slow growing right-sided neck mass that was intermittently painful over the last year. There were no complaints of difficulty swallowing or breathing. Physical examination identified a four centimeter mobile, painless right submandibular neck mass. Computed tomography (CT) revealed a 3.1 cm lesion superficial to the platysma and fine needle aspiration was non-diagnostic. Excision of the mass confirmed a grey, well circumscribed mass with gritty consistency. Pathological examination revealed an epithelial neoplasm arranged in a nest of basaloid cells forming shadow cells among a multinucleate giant cell reaction. This neck mass was believed to be a pilomatrixoma, a rare, benign neoplasm arising from hair cortex cells. These masses most commonly arise in children, but can occur at any age in both males and females. Typically, pilomatrixomas are located on the eyebrows, scalp, trunk, and upper extremities. Symptoms typically include pain, tenderness, and inflammation from a solitary mass ranging from 0.5 to 3 centimeters. CT scan, ultrasound, and Magnetic Resonance Imaging (MRI) can all be used in the diagnosis, but fine needle aspiration is usually the test of choice. Pathology typically demonstrates ghost cells, basaloid cells, and calcium deposition. Treatment is complete surgical excision, and recurrence is as a low as 1% following excision.
A 55-year-old Hispanic woman presented with a slow growing right-sided neck mass that was intermittently painful over the last year. There were no complaints of difficulty swallowing or breathing. Physical examination identified a four centimeter mobile, painless right submandibular neck mass. Computed tomography (CT) revealed a 3.1 cm lesion superficial to the platysma and fine needle aspiration was non-diagnostic. Excision of the mass confirmed a grey, well circumscribed mass with gritty consistency. Pathological examination revealed an epithelial neoplasm arranged in a nest of basaloid cells forming shadow cells among a multinucleate giant cell reaction. This neck mass was believed to be a pilomatrixoma, a rare, benign neoplasm arising from hair cortex cells. These masses most commonly arise in children, but can occur at any age in both males and females. Typically, pilomatrixomas are located on the eyebrows, scalp, trunk, and upper extremities. Symptoms typically include pain, tenderness, and inflammation from a solitary mass ranging from 0.5 to 3 centimeters. CT scan, ultrasound, and Magnetic Resonance Imaging (MRI) can all be used in the diagnosis, but fine needle aspiration is usually the test of choice. Pathology typically demonstrates ghost cells, basaloid cells, and calcium deposition. Treatment is complete surgical excision, and recurrence is as a low as 1% following excision.
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