Pilomatrixoma in a child mimicking a ruptured epidermal cyst clinically and histopathologically: Case report

INTRODUCTION AND IMPORTANCE: Pilomatrixoma is a superficial benign skin tumor that originates from the matrix cells of the hair follicles. It presents more frequently during the first two decades of life and usually involves the head and neck, most often in the eyelid or eyebrow area. CASE PRESENTATION: We present a case of pilomatrixoma, which appeared at the age of 14 years with history of recurrent inflammation and discharge mimicking a ruptured epidermal cyst. DISCUSSION: Pilomatrixomas are often confused clinically with other benign masses, encountered in the clinical practice more frequently like dermoid cysts and epidermal inclusion cysts. The rate of accurate preoperative diagnosis ranges between 0%–30% and the correct diagnosis can be established only after excision and histopathological examination. Our case demonstrates an atypical presentation of pilomatrixoma as an epidermal inclusion cyst. CONCLUSION: Ophthalmologists and ocular pathologists should be aware of the atypical presentation of pilomatrixomas to ensure early accurate diagnosis and curative treatment.