Cystic pilomatrixoma: a diagnostic challenge.

Results: Two children, ages 11 and 7, with cystic preauricular masses are presented. FNA of cyst contents was nondiagnostic and cyst cultures were negative. Computed tomography scans revealed cystic masses superficial to the parotid gland but no distinctive radiologic features characteristic of pilomatrixoma. Complete lesion excision via a preauricular facelift approach was performed in both cases. The histopathologic features included basaloid cells surrounding a cystic space containing keratin debris and characteristic ghost cells consistent with the diagnosis of pilomatrixoma. There has been no evidence of recurrence at 1 and 6 years follow-up, respectively.