Multiple pilomatricomas in a middle-aged woman

Abstract Pilomatricoma is a benign tumor arising in the head and neck region or upper limbs, described by relatively few oral surgery articles. A pilomatricoma is usually a single lesion and appears in children and young adults. We present a case of multiple pilomatricomas in a middle-aged woman. A 52-year-old woman was referred with suspected sialolithiasis in the left submandibular gland. A computed tomography (CT) scan revealed five globular high-density lesions within the neck and head. Ultrasonographic (US) examinations were performed on these five lesions. All of them were located under the skin and had oval shapes. Excisional biopsy was performed on the left submandibular lesion. Microscopically, under the fibroconnective tissue, lamellar bone, eosinophilic calcified structure, a basophilic portion with enucleated cells and shadow cells (ghost cells) were observed. However, typical basaloid cells were rare. After informed consent was obtained from the patient, follow-up observation was performed. There were no recurrences after excisional biopsy, and the other four lesions showed no change in their size or clinical features after two years of observation.