Slow-growing Nodular Lesion

Ahsen Hussain
MD, FRCOphth

Assistant Professor, Department of Ophthalmology & Visual Sciences
Dalhousie University

This 77-year-old man presents for assessment of a slow-growing, nodular lesion with regions of ulceration, scabbing, and telangiectasia. What could be the cause of this lesion?

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Analysis

Here, we see a basal cell carcinoma (BCC). This is the most common malignant tumor of the eyelid. This lesion typically presents on the lower eyelid, followed successively by the medial canthus, upper eyelid, and lateral canthus. BCC can also present as an innocuous papilloma or nevus; therefore, any suspicion of malignancy should warrant a biopsy. Gorlin syndrome is a rare genetic disorder characterized by multiple BCCs and other systemic findings.

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Video Analysis

In the accompanying 11 min. video featuring Dr. Ahsen Hussain, assistant professor at Dalhousie University in Nova Scotia, we will:

  • Learn how to identify a BCC
  • Review the treatment for BCC
  • Understand why it is important to be aware of cognitive biases and heuristics

Clinical Tip

Important questions to ask a patient with a lesion suspicious for BCC include history of significant sun exposure and blistering sunburns.