Pilomatricoma before and after excision. (Dr. Noorali Bharwani)
Pilomatricoma before and after excision. (Dr. Noorali Bharwani)

A 47 year-old male presented with a three-month history of a lump below the right eyelid. It was slowly getting bigger. The lump was excised under local anaesthetic.

Pathology report


Cyst right lower eyelid.
The specimen consists of a tan and brown irregularly shaped piece of skin measuring 1.3 x 0.5 x 0.2 cm. Attached is an underlying cyst-like structure measuring 1.0 x 0.5 x 0.5 cm. The cyst-like structure is extremely friable. The margins are marked with blue ink.


Consistent with proliferating pilomatricoma


Pilomatricoma is a benign cystic new growth.

Clinically, pilomatricoma usually presents in young individuals as a solitary cutaneous nodule with an average size of one cm and rarely exceeds 2 cm in diameter.

Proliferating pilomatricoma was first described in 1997.

The lesions are usually situated mostly on the head and neck.

The differential diagnosis includes classical pilomatricoma, pilomatrical carcinoma, and basal cell carcinoma.

These neoplasms should be excised with adequate surgical margins, and careful follow-up examinations are strongly recommended.

Proliferating pilomatricoma can occur at younger ages and should be considered in the differential diagnosis of solitary lesions in adults and children, even if the lesion is rapidly growing.

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