title: Epithelioma of Malherbe: new ultrasound patterns.
abstract: BACKGROUND
  Calcifying epithelioma of Malherbe, or Pilomatricoma, is considered an uncommon cutaneous neoplasia, normally occurring in children as a solitary, firm, asymptomatic, hard, subcutaneous, slowly growing nodule on the face, neck, or proximal upper extremity. In literature, two Pilomatricoma ultrasound patterns are described: the totally calcified nodule and the hypoechoic nodule with internal calcific foci. High frequency ultrasound has not yet been applied for routine diagnosis of Pilomatricoma. The aim of the study was to retrospectively identify specific ultrasound features.
  
  
  METHODS
  We retrieved 124 histologically Pilomatricoma cases: 28 patients with 32 lesions were preoperatively evaluated with ultrasound.
  
  
  RESULTS
  22/32 have shown a solid formation, hypoechoic, with a sharp outline. Of these 22, 10 lesions were completely calcifying and 12 partially calcified. In 3/32 lesions with uncertain diagnosis, ultrasounds showed a complex/mixed pattern with pseudo-fluid areas and microspots. 7/32 lesions with US different diagnosis included 3 complex lesions, 2 cystic lesions and 2 solid nodular lesions.
  
  
  CONCLUSIONS
  In addition to well-known ultrasound patterns (completely calcified and partially calcified) we identified three new, not yet described, patterns that constitute the 31% of the cases: complex, pseudocystic and pseudotumoral.
authors.affiliation: Struttura di Radiologia e Diagnostica per Immagini, Istituto Dermosifilopatico di Santa Maria e San Gallicano-IFO-Roma, Rome, Italy. solivetti@tiscalinet.it
authors.forename: Francesco M
authors.initials: FM
authors.lastname: Solivetti
authors.forename: Fulvia
authors.initials: F
authors.lastname: Elia
authors.forename: Alessandra
authors.initials: A
authors.lastname: Drusco
authors.forename: Chiara
authors.initials: C
authors.lastname: Panetta
authors.forename: Ada
authors.initials: A
authors.lastname: Amantea
authors.forename: Aldo
authors.initials: A
authors.lastname: Di Carlo
mesh_terms: D000293:Adolescent; D000328:Adult; D002277:Carcinoma / Q000000981:diagnostic imaging* / Q000473:pathology; D002648:Child; D003937:Diagnosis, Differential; D005260:Female; D006201:Hair Diseases / Q000000981:diagnostic imaging* / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D018296:Pilomatrixoma / Q000000981:diagnostic imaging* / Q000473:pathology; D012878:Skin Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D014463:Ultrasonography
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