Pilomatricoma of Pinna- A Maze that may Misdirects

Pilomatricoma is a rare cutaneous epidermal appendageal tumour having differentiation in the direction of hair cortex cells. It usually presents as single, less than 3 cm size, subcutaneous lesion, commonly seen in children, more commonly in head, neck and upper extremities. It can mimic a variety of other lesions clinically as well as cytologically, thereby posing a diagnostic challenge. The ear lobe is a very rare site for it to occur. The authors report a case of a 61-year-old female presented with history of non tender nodule on left ear lobe for six months. The lesion was clinically suspected as keloid, sebaceous cyst and chondroma, later diagnosed as pilomatricoma on fine needle aspiration cytology, confirmed further on histopathological examination. Sebaceous cyst has been ruled out due to the presence of characteristic findings in both cytology and histopathology. However, due to the inherent disadvantage of cytology, predominance of one component over the other would have mislead the diagnosis. It is being reported for its rare location, unusual age of presentation and to report its mimics on cytology.