A 32-year-old man was referred to our department for presenting a pedunculated lesion with a clinical diagnosis of pyogenic granuloma, 1 cm high and 0.6 cm in diameter at its base, reddish in colour, with vascular ingurgitation, located on the free edge of the middle third of the right upper eyelid, with no pain or bleeding, and a year of evolution. The rest of the ophthalmological and systemic examination was normal.

The lesion was surgically excised by making a full-thickness pentagon that included the lesion. The histopathological diagnosis was pilomatricoma due to the description of a solid, encapsulated mass consisting of a mass of pilomatric cells arranged in the periphery, large masses of keratin and isolated areas of ghost cells, with granulomatous reaction to adjacent foreign body. At higher magnification, small basalioid cells without cytological atypia are identified. In the more central area, the cells are larger, with eosinophilic cytoplasm and loss of the nucleus (phantom). Between these two predominant cell types there are transitional cells.

After 4 years of follow-up no recurrence or malignancy has been observed.