Pilomatrix carcinoma in the lower eyelid: case report

Area of Science:

• Oncology
• Dermatology
• Ophthalmology

Background:

• Pilomatrix carcinoma is a rare, low-grade malignant tumor originating from the hair follicle matrix.
• It is frequently misdiagnosed due to histological similarities with other basaloid epithelioid tumors.
• Periorbital involvement is exceptionally rare, with only five previous cases documented.

Purpose of the Study:

• To report a novel case of pilomatrix carcinoma involving the periorbital region.
• To highlight the diagnostic challenges and clinical presentation of this rare tumor.
• To emphasize the importance of considering pilomatrix carcinoma in atypical periorbital lesions.

Main Methods:

• A case study of an 85-year-old male with a rapidly enlarging right lower eyelid mass.
• Clinical examination, lesion excision, and subsequent histopathological confirmation.
• Surgical management included lesion excision and eyelid reconstruction.

Main Results:

• Histopathology confirmed the lesion as pilomatrix carcinoma with clear surgical margins.
• The tumor presented as a painless, rapidly enlarging, nodular lesion on the medial lower eyelid margin.
• The patient underwent successful excision and reconstruction with clear margins.

Conclusions:

• Pilomatrix carcinoma should be considered in the differential diagnosis of atypical periorbital masses.
• Early recognition and appropriate surgical management are crucial for favorable outcomes.
• This case adds to the limited literature on periorbital pilomatrix carcinoma, underscoring its rarity and diagnostic considerations.