Pilomatrix carcinoma in the lower eyelid: case report

Pilomatrix carcinoma is a rare, low-grade malignant tumour of the hair follicle matrix, often misdiagnosed due to its histologic similarity to other more common basaloid epithelioid tumours. While it predominantly affects the head and neck region, periorbital involvement is exceptionally rare, with only five reported cases. We present a novel case of pilomatrix carcinoma in the right lower eyelid, representing the sixth documented periorbital occurrence. An 85-year-old male presented with a painless, rapidly enlarging mass on the right lower eyelid, accompanied by red discoloration and ectropion. Examination revealed a firm, nodular medial lower lid margin lesion measuring 3 × 2 × 4 mm. An excision of the lesion with lid reconstruction was performed, and histopathology confirmed the lesion as pilomatrix carcinoma with clear margins. This case highlights the importance of considering pilomatrix carcinoma in atypical periorbital lesions.