Nodular Basal Cell Carcinoma

Some skin neoplasms are quite subtle and do not present as obvious exophytic lesions. This basal cell carcinoma presented as a subtle area of asymptomatic discoloration under the patient’s eye.

A 76-year-old man presented for a periodic routine total body skin exam. His medical history included many actinic keratoses and several non-melanoma skin cancers.

Key point: There was a subtle area of asymptomatic discoloration under his right eye. Notably, there was also some increased vascularity in the area. A biopsy showed nodular basal cell carcinoma.

Treatment: The patient’s tumor was removed easily by Moh's micrographic surgery. 

Note: Some skin neoplasms are quite subtle and do not present as obvious exophytic lesions. Periodic examinations prove quite useful in detecting such neoplasms at an early stage.