Abstract

Background: Basal cell carcinomais a slow growing malignant cutaneous non melanocytic tumor that is locally aggressive but it rarely metastasizes. Case of 61 year male presented to the outpatient department with a round, nonhealing ulcer with hyperpigmentation, measuring 2.5x2.1x0.8cm over the right side of face, 1.8 cm below the right eye region for the last 1.5 years. Patient had history of swelling at same site 1.5 year back, as small nodular lesion which was excised. The general physical and systemic examinations were normal. The lesion was surgically excised with wide margins. The specimen on gross measured 2.3x2.1x0.6cm, firm, grey brown to black colored hyperpigmented with rolled out margins and central ulceration measuring 1.6x1.4x0.6cm. Cut section was grey white, nodular with blackish pigmentations. On microscopic examination showed a circumscribed nodular lesion composed of neoplastic cells arranged in large basaloid lobules with peripheral nuclear palisadations. The neoplastic basaloid cells with scant cytoplasm and hyperchromatic nuclei were seen. The stroma was fibromyxoid with focal inflammation. The surface ulceration was noted. The nodules are variable size of more than 0.3cm diameter. Tumor showed epidermal attachment. In areas the reticulate, pseudoglandular pattern of basaloid neoplastic cells were noted with a mucinous stroma. Focal areas of colonization of tumor's complexes with melanocytes and stromal melanophages pigmentation was noted. The tumor showed 0.5cm depth of invasion. The mitotic activity was low, minimal atypia and apoptosis were noted. The lymphovascular, perineural invasion was absent. All peripheral and deep surgical margins were free from tumor. On histopthological findings reported as Basal cell carcinoma-nodular, adenoid cystic and pigmented: mixed histological subtype over face. The patient was kept on regular follow up. There was no evidence of recurrence or any metastasis. Conclusion: We present this rare case of Basal cell carcinoma-nodular, adenoid cystic and pigmented: mixed histological subtype for its clinical and morphological findings. The pathological diagnosis and classification of BCC are essential for the evaluation of the tumour type, its biological behaviour, risk assessment of the recurrence and treatment.

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