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Case Reports
. 2020 Dec 3;8(12):e3234.
doi: 10.1097/GOX.0000000000003234. eCollection 2020 Dec.

Basal Cell Carcinoma with Sebaceous Differentiation: A Case Report and Review of Literature

Hani Ali Shash  1 , Sawsan Fahad Almarzouq  1 , Abdulrahman Abdulaziz Alghamdi  2 , Jumana Abdulwahab Alratroot  3
Affiliations
Case Reports

Basal Cell Carcinoma with Sebaceous Differentiation: A Case Report and Review of Literature

Hani Ali Shash et al. Plast Reconstr Surg Glob Open. .

Abstract

We report a very rare type of tumor in the left nasal ala in an elderly patient. An 81-year-old Saudi woman known to have hypertension, osteoporosis, and rheumatoid disease (who had been compliant to her medications) presented with a 0.5-cm fixed, firm, round well-defined nodule on the left ala of the nose (with crusting, erosion, and telangiectasia of the overlying skin), whose size had been gradually increasing for 2 years. The patient underwent excisional biopsy, and the specimen was sent for a histopathologic analysis. Macroscopic examination showed a round tan-white homogenous nodule, measuring 0.6 × 0.5 × 0.5 cm3. Microscopic examination revealed a fairly circumscribed unencapsulated dermal lesion, featuring basaloid cells with peripheral palisading, and focal stromal clefting. The final diagnosis of basal cell carcinoma with sebaceous differentiation was made. The patient was managed with Mohs surgery with clear margins, and full-thickness skin graft was done. Four months after surgery, the patient had a recurrence, which was managed with a surgical excision (with 4-mm margin) and covered by a full-thickness skin graft.

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Conflict of interest statement

Disclosure: The authors have no financial interest to declare in relation to the content of this article.

Figures

Fig. 1.
Fig. 1.
Preoperative picture of the patient with a left nasal nodule.
Fig. 2.
Fig. 2.
Histologic images showing dermal nodules of basaloid cells admixed with sebaceocytes. H&E ×200.
Fig. 3.
Fig. 3.
D2-40 immunohistochemical staining featuring focal and weak positivity of the basaloid cells. ×200.
Fig. 4.
Fig. 4.
Postoperative picture of the patient, showing signs of recurrence.
See this image and copyright information in PMC

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