Pilomatricoma in Temporal Bone and Parotid Gland: A Case Report

Introduction: Pilomatricomas are benign and slow-growing skin neoplasms of follicular cell origin usually present in the head and neck region with a bimodal distribution in children and adults over 60 years of age. Most pilomatricomas are solitary, firm and less than 1 cm in diameter and can be included into the differential diagnosis of cervical noninflammatory masses of the salivary gland.

Objective: This study aims to report a case of a giant pilomatricoma had an uncommon presentation.

Case Report: We report a rare case of a giant pilomatricoma of the parotid and temporal right bone affecting a 46-year-old woman presented with a new daily headache, progressive hearing loss, and peripheral facial palsy during one year. A tomographic exam showed a calcified mass into her right parotid gland eroding through the temporal bone. She underwent two biopsies in the parotid gland, and temporal bone to conclude diagnostic. Partial parotidectomy and mastoidectomy with apparent complete resection of the tumor were proceeded.

The tumor recurred as invasive growth 3 months after surgery when the carotid occlusion test was done for later total parotidectomy and petrosectomy procedures.

Conclusion: Surgical excision is the treatment of choice to minimize the risk of malignant transformation. The absence of reports dealing with these oversized lesions in literature and the lack of expertise with the diagnosis prompted us to describe a case of giant pilomatricoma, that was diagnosed as a malignant tumor, because of its rapid evolution.