Linear Basal cell carcinoma in an asian patient

Abstract

Linear basal cell carcinoma (BCC), which has a ratio of its long and short axes of more than 3: 1, is a distinct clinical entity among BCC. We report the first case report of a linear BCC in an Asian patient. An 87 year-old woman presented with an ulcerated black nodule, 15x5mm (3: 1), on her nasojungal fold of the right lower eyelid. The tumor was excised with 5 mm safety margin. The pathological examination confirmed the tumor was a BCC with a clear margin. Diagnosis of a linear BCC is based on its morphological features and occurrence along the wrinkle line, which needs to be also considered in Asian.

Fig. (1)

A black ulcerated nodule, 15 x 5 mm (3: 1), can be seen on the nasojungal fold of the right lower eyelid. The lower eyelid shows medial ectropion and the lateral margin of it is situated to around the half of the lower eyelid.

Fig. (2)

The linear basal cell carcinoma was excised with 5 mm safety margin. As the skin had been pulled toward the tumour, when the traction was released, the defect became very large.

Fig. (3)

The defect was reconstructed with a cheek rotation flap for the lower eyelid area and a nasolabial VY advancement flap for the medial canthal area.

Fig. (4)

Pathological specimen (Hematoxylin and Eosin). Typical “nodular” subtype is demonstrated. a. Tiny tumor islands are demonstrated. (bar = 200 μm) b. The magnification of the rectangle in a. Palisading (allow) and clefting (star) are shown. (bar = 100 μm).

Fig. (5)

Postoperative findings show no local recurrence or lower eyelid ectropion. By reconstructing the lower eyelid suspending laterally, the lower eyelid slope toward nasally was made to flow the lacrimal fluid.