Pilomatrixoma of the eyelids and eyebrows in children and adolescents

Purpose: To review the clinical features of pilomatrixomas of the eyelids a nd eyebrows in children and adolescents. Methods: The authors reviewed the medical records of 95 patients, all of wh om were 20 years old or younger and had the histopathologic diagnosis of pi lomatrixoma made from 1976 through 1995. Special attention was given to tha t subgroup of patients with tumors involving the eyelids and eyebrows. Data analyzed included age at diagnosis, patient sex, location and size of tumo r, preoperative diagnosis, and clinical description of tumor. Results: Eleven (12%) of 95 patients had lesions involving the eyelid or ey ebrow. Six of those patients (55%) were female. Eight patients (73%) were 1 0 years old or younger, and three were 11 to 20 years old. The tumor occurr ed on the upper lid or in the brow in eight patients, the lower eyelid in t wo patients, and the medial canthus in one patient. Tumor diameter was 1 cm or less in all II patients. Pilomatrixoma was included in the preoperative differential diagnosis in only four of the 11 patients. The most common mi sdiagnoses were epidermoid and dermoid cyst. Three patients had pink or blu e discoloration of the overlying skin, two had visible yellow-white patches in the tumor, and two had dilated vessels on the tumor surface. Conclusions: Pilomatrixoma is an uncommon tumor that can occur on the eyeli ds and in the brow region of children and adolescents. It is commonly misdi agnosed preoperatively as an epidermoid or dermoid cyst. Distinctive clinic al features, however, suggest the correct diagnosis.