Epithelioma of Malherbe: new ultrasound patterns.
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.
Solivetti
Francesco M
FM
Struttura di Radiologia e Diagnostica per Immagini, Istituto Dermosifilopatico di Santa Maria e San Gallicano-IFO-Roma, Rome, Italy. solivetti@tiscalinet.it
Elia
Fulvia
F
Drusco
Alessandra
A
Panetta
Chiara
C
Amantea
Ada
A
Di Carlo
Aldo
A
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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