The tone for a fierce clash was set after 12 minutes when Matuzalem caught Nenad Krsticic with a late tackle.
Ktsticic was forced out of the match through injury, while Matuzelam picked up a yellow card for the challenge.
The visitors went ahead on 28 minutes thanks to the quick thinking of forward Eder.
His low free kick caught a jumping wall by surprise and nestled neatly into the bottom corner, with Sebastian Frey unable to read the instinctive strike in time.
A tight match was changed completely with 12 minutes left as Sampdoria defender Andrea Costa was sent off for a second bookable offence.
Genoa took full advantage to equalise just two minutes later through Matulazem, who sent a looping strike into the penalty area that evaded everyone to find the top corner.
Both sides struggled to control possession in frantic finish and ultimately had to settle for a point each.