Paediatric cervical pilomatrixoma: clinical and ultrasound approach to an unexpected mass

Dermal lesions in the paediatric population are a frequent reason for consultation that requires a systematic evaluation due to their broad differential diagnosis, including infectious processes, malformations, and tumors.

We present the case of a 9-year-old boy with a three-month history of a left-sided cervical lesion. The mass was hard, bluish in color, and showed progressive growth despite topical antibiotic therapy. Bedside clinical ultrasound identified hyperechoic areas suggestive of calcifications, leading to an initial diagnosis of pilomatrixoma. This was supported by a formal ultrasound and confirmed by histopathological study following surgical excision.

Pilomatrixoma should be considered in the differential diagnosis of pediatric cervical masses. Clinical ultrasound is a key tool that allows for early diagnostic orientation, optimizing referral and avoiding unnecessary tests or interventions.