The great mimicker: a case of neck pilomatricoma masked as submandibular gland

Abstract

Lateral neck swelling is common in general population usually it could be from the salivary gland mass namely parotid or submandibular gland. It could also be cervical lymphadenopathy. However, in this case a rare finding was discovered.  We report a case of a 12-year-old boy presented with right cervical neck swelling which increase in size over the past 4 weeks and associated with pain. Clinically it measures 2×2 cm located at right lower cheek close to submandibular gland region.  Excision biopsy was performed. The microscopic description showed multiple pieces of tissue, many are composed of basaloid cells that show abrupt keratinisation without granular layer into ghost cell. Other pieces show multinucleated giant cell of foreign body type reaction. The final diagnosis is pilomatricoma. This is a benign skin tumour derived from the hair matric. It is relatively uncommon and typically occur on the scalp, face and upper extremities. Although it rare to occur at the submandibular region medical professional should be alert and aware that one of the differential diagnoses for the subcutaneous lateral neck mass could be a pilomatricoma.