Inflamed and Calcified Pilomatrixoma of the Mandibular Angle Mimicking an Epidermoid Cyst: A Case Report

Pilomatrixoma is a benign hair follicle tumor seen mainly in children and young adults.Its diagnosis may be less straightforward when inflammation changes the usual clinical appearance.We describe the case of a 14year-old girl with a one-year history of swelling at the left mandibular angle.The lesion had repeatedly discharged blood and pus, becoming smaller after discharge before enlarging again.Three connected nodules were eventually noted, and an epidermoid cyst was initially suspected.Ultrasound showed a solid subcutaneous lesion with echogenic foci and posterior acoustic shadowing.Computed tomography (CT) demonstrated internal calcification and raised the possibility of pilomatrixoma before surgery.The lesion was completely excised, and histopathology confirmed an inflamed and calcified pilomatrixoma without malignant changes.Recovery was uncomplicated.This case draws attention to an inflammatory presentation of pilomatrixoma that can resemble an epidermoid cyst and shows how calcification on imaging may help guide the diagnosis when the clinical findings are misleading.