Polypoid basal cell carcinoma on the face

Abstract

Dear Editor, Basal cell carcinoma (BCC) as a polypoid tumor is very rare, especially on the face. It is unusual but possible for BCC to present a pedunculated feature. We describe a case of polypoid BCC on the face.A 70-year-old man presented a 10-year-old mass under the left eyelid region. The mass was a smooth, elliptical, and blackish-brown pedunculated polypoid tumor 7-mm across at maximum. We diagnosed it pathologically as the solid type of BCC. It is unusual but possible for BCC to present a pedunculated feature. It is significant to think of BCC as a differential diagnosis when we see a blackish polypoid tumor.The patient was a 70-year-old male who visited our clinic for tinea pedis. We recognized a pedunculated polypoid growth on his left palpebra although that was not his main complaint. He described how he had that tumor for more than 10 years and it had grown bigger. A soft mass, 7-mm across at maximum, was pedunculated on the lower part of the left eye absconsio. The whole mass was a blackish brown, while the stalk had a normal skin color. The surface was flat, elliptic and smooth (Fig. 1). Clinically, the differential diagnoses were of neurofibroma or a pigmented nevus.We performed a local excision with a small margin. The skin specimen revealed tumor of nests, composed of basaloid cells, extending from the upper dermis to the lower layer ( Fig. 2a). Each nest had rich melanin. Peripheral palisading and clefts between tumor nests and stroma were observed (Fig. 2b). The tumor aggregations were limited to the polypoid area and surgical margins were negative. Neither keratinization, cystic structure nor follicular differentiation were observed.We diagnosed this tumor as a solid type BCC.In the 12 months since the operation, there has been no recurrence.As the majority of skin carcinomas, BCC occupies approximately a half of all skin carcinoma cases. The occurrence of BCC in the form of a polypoid tumor, however, is an unusual clinical presentation, 1 except for the premalignant fibroepithelial tumor (Pinkus tumor), a variation of BCC. The tumor reported here is a very rare distinctive clinicopathological variant.In our case, histologically, tumor aggregations were restricted to a pedunculated zone. McElory et al. Figure 1. Clinical feature was a pedunculated blackish polypoid tumor.

Polypoid Basal Cell Carcinoma on the Nose Tip

“…e author characterized BCC as follows: polypoid appearance, female predominance, and tumor restriction within the polypoid area. Our search identified 22 previously reported cases of polypoid BCC described in the English literature (Table 1) [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18]. In our search, Gaughan [3] reported a giant pedunculated BCC on the forearm which arose from burn scar.…”