Facial Pilomatrixoma in a Child: A Rare Differential for a Soft Tissue Lesion

Pilomatrixoma is an uncommon benign skin tumor originating from hair matrix cells, most frequently observed in children. Due to its slow growth and nonspecific presentation, it is often misdiagnosed as other skin or soft tissue lesions. A high index of suspicion is crucial for early recognition and appropriate management. We report the case of an eight-year-old boy who presented with a gradually enlarging, firm, non-tender, mobile swelling on the right cheek over two years. The mass, located anterior and slightly inferior to the right ear near the angle of the mandible, had no associated history of trauma or systemic illness. Surgical excision under general anesthesia was performed. Histopathological examination confirmed the diagnosis of pilomatrixoma. No preoperative imaging was performed, as clinical assessment favored a benign superficial lesion. The patient recovered uneventfully, and no recurrence was observed during a six-month postoperative follow-up. This case underscores the importance of including pilomatrixoma in the differential diagnosis of pediatric facial masses. While our follow-up duration was limited to six months, no signs of recurrence were noted during that period. Timely clinical recognition and complete surgical excision generally yield excellent outcomes, although longer-term surveillance is ideal.