A 70 years old patient presents with a lesion on the cheek with raised, pearly borders and with telangiectasias on surface of the lesion. What is the likely diagnosis?
(A) Basal cell carcinoma (B) Squamous cell carcinoma (C) Was (D) Actinic keratosis
(A) Ans: A. Basal cell carcinoma(Ref: Harrison 19/c p500; Robbins 9/e p1157)Lesion on the cheek with raised, pearly borders and with telangiectasia on surface of the lesion is highly suggestive of basal cell carcinoma.Basal cell carcinomas:Present as pearly papules containing prominent dilated subepidermal blood vessels (telangiectasias).Arises from epidermal basal cells.Present as a small, slowly growing pearly nodule, often with touous telangiectatic vessels on its surface, rolled borders, and a central crust (nodular BCC).The occasional presence of melanin in this variant of nodular BCC (pigmented BCC) may lead to confusion with melanoma.Morpheaform (fibrosing), infiltrative, and micronodular BCC, the most invasive and potentially aggressive subtypes, manifest as solitary flat or slightly depressed, indurated whitish, yellowish, or pink scar-like plaques.