[Medial canthus pilomatrixoma in an 80-year-old patient]

An 80-year-old lady noticed a painless "swelling" in the medial canthal region 3 months. The tumor showed a reddish color due to a recurrent superficial bleeding for 2 weeks. Clinically the tumor was supposed to be a super-infected keratoacanthoma. The differential diagnosis included an ulcerative basal cell carcinoma. Excisional biopsy and reconstruction using a free graft from the ipsilateral upper lid were performed. Histopathologically the lesion proved to be a "benign calcifying epithelioma Malherbe" (pilomatrixoma). Today, 8 years after surgery, there was no recurrence of the tumor. A circumscribed, subepidermal, movable reddish or livid tumor of the upper lid, eye brow or of the canthal region should be suggestive of pilomatrixoma, not only in young females.