Nodular Basal Cell Carcinoma
This picture shows a good example of a nodular basal cell carcinoma (BCC). Note the raised, pearly edges, telangectasia and central ulceration. The inner canthus is a classical site for BCCs.
This BCC displays all the characteristics seen in Fig 1, but has a less regular border and displays more marked ulceration in the centre.
This BCC displays all the characteristics seen in Fig 1, but has a less regular border and displays more marked ulceration in the centre.
BCCs on the lower eyelid are associated with a higher morbidity as they are often diagnosed late, making reconstruction more challenging.
This lesion has arisen in the area on which the patient rests their glasses. This can be easily overlooked, but the raised pearly edge and telangectasia identify it as a BCC.
This is a large BCC, in a site which is a reconstructive problem.
Features
Clinically, Nodular BCCs appear with the "classic" signs of painless, translucent, raised lesions with pearly edges, telangectasia and central ulceration, which sometimes bleed intermittently in response to minor trauma.
Nodular BCCs are found mainly on the head, neck and upper back.
Micronodular basal cell carcinomas, which make up 15% of Nodular lesions, have been singled out as a subgroup which is likely to recur. This is determined histologically.
Incidence
Nodular lesions make up 50% of all BCCs.
Differential Diagnosis
Non-pigmented naevi. Keratoacanthoma. Squamous cell carcinoma. Neuroma. Amelanotic malignant melanoma.
Treatment
The best forms of treatment for a primary nodular BCC are shown below. Note: "Large"=>2cm.
Nodular, small and low-risk site
Excision is the treatment of choice. Cryosurgery or curettage and cautery are also effective.
Nodular, small and high-risk site
Excision is the treatment of choice. Cryosurgery, radiation therapy or Moh's micrographic surgery are also effective.
Nodular, large and low-risk site
Excision is the treatment of choice. Cryosurgery, radiation therapy or curettage and cautery are also effective.
Nodular, large and high-risk site
Moh's micrographic surgery is the treatment of choice. Excision and radiation therapy are also effective.
