Pilomatricoma, a benign neoplasm with hair matrical differentiation was earlier referred to as ‘Calcifying epithelioma of Malherbe’
because of the associated extensive calcification. More recently, it has been aptly rechristened as “Pilomatricoma” due to the
predominant hair matrical differentiation that it exhibits. Besides its matrix, pilomatricoma may show diverse differentiation along the
other constituents of the hair follicle like the inner sheath and infundibulum because of which it may present some diagnostic
difficulties to the Pathologist. Barring these exceptional features, histopathology is the gold standard in the ultimate diagnosis of
pilomatricoma. Histopathological features of trichelemmal cyst and basal cell carcinoma with basaloid differentiation closely resemble
those of pilomatricoma. Distinction from basal cell carcinoma is extremely important because of the prognostic implications and the
differences in management.
We present a case of pilomatricoma with classic histopathological features but with exceptional presenting features like occurrence at
70 years of age which is very unusual and absent calcification.