362 Acta Clin Croat, Vol. 53, No. 3, 2014 Acta Clin Croat 2014; 53:362-364 Case Report PERIOCULAR PILOMATRIXOMA: CASE REPORT Ana Bišćan Tvrdi 1 , Biljana Kuzmanović Elabjer 2 , Daliborka Miletić 2 , Mladen Bušić 2 , Damir Bosnar 2 and Zvonko Petrović 3 1 Medikol Polyclinic; 2 Clinical Department of Ophthalmology, 3 Clinical Department of Pathology and Cytology, Sveti Duh University Hospital, Zagreb, Croatia SUMMARY – Te aim is to present a case of pilomatrixoma in the periocular area in a 10-year- old female through retrospective review of medical records of a single patient. A 10-year-old female developed a lesion under her right eyebrow over a period of one year. Te rest of the ophthalmic history was unremarkable. On examination, oval, well-defned, subcutaneous tumor measuring 7x4 mm was found under the right eyebrow. It gave bluish tint under the frmly adherent overlying skin of normal color and texture. Rocky hard and non-tender, it was mobile over the underlying tissues. Total excision biopsy was performed under general anesthesia. Histopathologic analysis confrmed the diagnosis of pilomatrixoma. Pilomatrixoma is a rare tumor with head, neck and periocular area being the commonest sites. It is often clinically misdiagnosed and/or missed on diferential dia- gnosis. Although a benign tumor, malignant transformation into pilomatrix carcinoma has been described. Tus, total surgical excision of the mass is recommended. Key words: Pilomatrixoma – surgery; Periocular area; Skin neoplasms – pathology; Case reports Correspondence to: Ana Bišćan Tvrdi, MD, Medikol Polyclinic, Voćarska 106, HR-10000 Zagreb, Croatia E-mail: anabiscan@yahoo.com Received August 6, 2013, accepted June 16, 2014 Introduction Pilomatrixoma is a rare, benign, cutaneous tumor arising from pluripotential precursors of hair matrix cells. Lids and eyebrows are common sites of its ap- pearance 1 . Malignant transformation into pilomatrix carcinoma has been described 2 . We present a case of pilomatrixoma of the eyebrow in a 10-year-old fe- male. Case Report A 10-year-old female presented with a painless mass under the right eyebrow, slowly growing for one year. Her medical history was otherwise unremark- able. On examination, oval, well-defned, subcutane- ous tumor measuring 7x4 mm was found under the right eyebrow. It gave bluish tint under the frmly adherent overlying skin of normal color and texture. Rocky hard and non-tender, it was mobile over the underlying tissues (Fig. 1). Total excision biopsy was performed under general anesthesia. Macroscopically, the well circumscribed, multilobular yellow-grey tu- mor had a diameter of 7 mm. Histopathologic analy- sis revealed numerous islands of epithelial cells com- posed mostly of eosinophilic shadow cells, which are pathognomonic of pilomatrixoma. Calcifcation was also present (Fig. 2). Discussion Pilomatrixoma (also called pilomatricoma or Mal- herbe calcifying epithelioma) 1-6 is a rare, benign, cu- taneous tumor arising from pluripotential precursors of hair matrix cells. Although the lesion can appear at any age 6 , it is most common in the frst two de- cades of life 3 afecting females more than males 5 . It can appear on any part of the body, the commonest being head and neck 1,2,4,6 , followed by upper extremi- ties, trunk and lower extremities. In periocular area, it