Intraosseous hair-induced cyst-like lesion of the maxilla associated with trichotillomania: first reported case and review of the literature

Heterotopic hair in the oral cavity is a rare condition, with possible etiologies including prior skin graft reconstruction, oral and maxillofacial trauma, or, in some clinical context, no identifiable cause. We report a case of a patient with trichotillomania who presented with a persistent sinus track opening between teeth #9 and #10 and a well-defined periradicular lesion in the area. Microscopically, it revealed a partially lined cyst-like entity containing terminal hairs, associated with a foreign body-type giant cell reaction. The patient admitted to a habit of repeatedly pulling and plucking her hair, placing it in her mouth, and occasionally pressing it against the area of concern. To our knowledge, this is the first reported case of an intraosseous hair-induced cyst-like entity with foreign body reaction in the anterior maxilla associated with trichotillomania.