HSS Ultrasound of the Month Case 161

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Clinical History

49 year old male with focal painless soft tissue swelling on the dorsum of the right hand.

Ultrasound of the Month – Case 161
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Diagnosis: Pilomatrixoma (Calcifying Epithelioma of Malherbe)

Pilomatrixoma, also known as calcifying epithelioma of Malherbe, is a benign tumor of hair follicle matrix.

Presents as a solitary, painless, and firm nodule on a hair-bearing surface.

More common in the pediatric population but may also occur in adults, with a bimodal distribution.

Ultrasound can be used to differentiate these tumors from cysts and, if characteristic heterogeneous echotexture and calcifications (with or without posterior shadowing) are present, can suggest the correct diagnosis.

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