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Pathology Quiz 4
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Yichieh Shiuey, MD | Massachusetts Eye and Ear Infirmary, Harvard Medical School

September 7, 1997
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Figure 1
This is the pathology of an eyelid lesion FROM a 67 year old man
Questions and Answers
1. What is the diagnosis?
Answer: Basal cell carcinoma

2. What are the pathological findings shown?
Answer: Nests and cords of bluish cells with palisading of cells at the tumor border, which is characteristic of basal cell carcinoma. Another characteristic finding in basal cell carcinoma would be a clear space between tumor cells and dermis, which represents a clefting artifact due to processing.

3. How common is this type of lesion?
Answer: Basal cell carcinoma represents approximately 20% of all eyelid tumors and is the most common of malignant eyelid tumors. Basal cell carcinoma represents 90% of malignant eye-lid tumors.

4. Does this lesion metastasize?
Answer: Basal cell carcinoma is usually locally infiltrative and only rarely metastasizes.

5. What is the treatment of this lesion?
Answer: Usually, the treatment of this lesion is complete local excision. However, if the tumor invades INTO the orbit, which occurs more frequently in medial canthus tumors, treatment may require exenteration.

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