PILOMATRICOMA: A CASE REPORT AND INTRAORAL SURGICAL APPROACH

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Pilomatricoma is a rare benign neoplasm arising from the hair follicle that mainly affects the head, neck, and upper extremities. A 21-year-old white female patient presented with a 1-year history of painless lesion in the right nasolabial fold. Clinically, it presented as a well-circumscribed nodule measuring 2 cm. For esthetic purposes, excisional biopsy was performed by intraoral access, and the diagnostic hypothesis of sebaceous cyst was considered. Histopathologic examination revealed anucleated epithelial cells (named ghost cells or shadow cells) in a lobulated pattern and sometimes presenting basaloid cells in the periphery. The presence of keratin, calcifications, and chondroid material was also observed. Based on these findings, the histopathologic diagnosis of pilomatricoma was established. This case reinforces the importance of the oral pathologist’s knowledge about skin lesions that may be in close contact with oral mucosa as well as the possibility of surgical excision by intraoral access, avoiding unwanted scars. Pilomatricoma is a rare benign neoplasm arising from the hair follicle that mainly affects the head, neck, and upper extremities. A 21-year-old white female patient presented with a 1-year history of painless lesion in the right nasolabial fold. Clinically, it presented as a well-circumscribed nodule measuring 2 cm. For esthetic purposes, excisional biopsy was performed by intraoral access, and the diagnostic hypothesis of sebaceous cyst was considered. Histopathologic examination revealed anucleated epithelial cells (named ghost cells or shadow cells) in a lobulated pattern and sometimes presenting basaloid cells in the periphery. The presence of keratin, calcifications, and chondroid material was also observed. Based on these findings, the histopathologic diagnosis of pilomatricoma was established. This case reinforces the importance of the oral pathologist’s knowledge about skin lesions that may be in close contact with oral mucosa as well as the possibility of surgical excision by intraoral access, avoiding unwanted scars.