Pilomatrixoma, also called epithelioma of Malherbe, is a benign neoplasm derived from hair follicle matrix cells. It usually presents as a solitary mass in the head and neck region and is more frequent in children and young adults, females, and the Caucasian population. Lesions equal to or greater than 5 cm are categorized as giant pilomatrixomas. We present a case of a 75-year-old female, with no known medical history, who was brought to the emergency department (ED) after falling on the street. She had a giant soft head tissue tumor, severe anemia due to intralesional chronic small hemorrhages and folates and cobalamin deficiencies, and delirant speech. The anatomopathological result of the biopsy of the tumor revealed to be a pilomatrixoma. The patient was then referred to plastic surgery, with complete excision of the tumor. After surgery, she was transferred to the psychiatric team, who assumed the delirant speech to be in the context of schizophrenia. She was discharged four months after admission.

UNASSIGNED: Pilomatricoma is a rare and benign tumor affecting children and adolescents. It originates from the matrix cells of hair follicles, the usual sites being head-neck and upper extremities. Due to its rarity, it is often misdiagnosed delaying definitive treatment. We report a case of pilomatricoma over the left gluteal region in a young Nepalese girl that was initially thought to be a calcified granuloma.
UNASSIGNED: A six-year-old girl presented with a painful swelling over the left buttock for one year that was gradually increasing in size. On examination, a solitary, well-circumscribed, tender swelling with hard consistency and a bumpy irregular surface measuring 3 × 2 cm was noted over the subcutaneous plane of the left gluteal region. Surgical excision of the mass was done which demonstrated features of pilomatricoma on histopathological examination (HPE). She recovered and remained disease-free at one year follow-up.
UNASSIGNED: This case highlights one of the handful presentations of pilomatricoma involving the buttock. Pilomatricoma is rarely considered a differential diagnosis of benign masses, the diagnosis of which is ascertained mostly after an HPE of the excised specimen. Surgical excision with clear margins is not only diagnostic but therapeutic in most situations.