A Case Report on Pilomatrix Carcinoma of the Right Temple: A Rare Malignancy

ntroduction/Aims: Pilomatrix Carcinoma (PC) is a rare malignant cancer of the hair follicle matrix cells. Our case report presents surgical management of a 59-year-old gentleman with PC of the right temple and subsequent follow-up. We aim to raise awareness of this rare malignancy with a high risk of local recurrence, including differential diagnoses, prognosis and management.

Case: A 59-year-old gentlemen was referred to the oral and maxillofacial department from dermatology for a 12-week history of a rapidly growing nodule on the right temple. Clinically, differential diagnoses included squamous cell carcinoma or merkel cell carcinoma, another rare malignancy. Wide local excision with local flap reconstruction was completed, with subsequent further wide local excision, sentinel node biopsy and full thickness skin graft. Histology reported no further evidence of malignancy and scans showed no evidence of lymph node involvement or metastasis. The patient is being followed up with CT scans six monthly for two years in the first instance.

Conclusion: There are few cases reported of PC in the literature. It is important to be aware of this rare malignancy that can present in the head and neck region due to its aggressive nature. Adjuvant treatment and follow up protocols are not clearly defined. The importance of accurate histological diagnosis is vital in the management of malignant pathology.