Nodular basal cell carcinoma masquerading as traumatic laceration

Area of Science:

• Ophthalmology
• Dermatology
• Oncology

Background:

• Periocular lesions can present with varied clinical signs.
• Traumatic injuries and neoplastic processes may share similar initial presentations.
• Basal cell carcinoma (BCC) is a common skin malignancy affecting the ocular region.

Purpose of the Study:

• To highlight the diagnostic challenges in differentiating traumatic eyelid injuries from periocular malignancies.
• To emphasize the importance of a high index of suspicion for basal cell carcinoma (BCC) in periocular lesions.
• To underscore the need for histological confirmation in suspected cases.

Main Methods:

• Clinical examination of a patient presenting with a periocular defect.
• Differential diagnosis between traumatic laceration and neoplastic lesion.
• Performance of punch biopsies for histological analysis.

Main Results:

• Ophthalmic review revealed an ulcerated lesion at the left medial canthus, not a simple laceration.
• Histology confirmed the lesion as basal cell carcinoma (BCC).
• The clinical presentation mimicked a traumatic injury secondary to a fall.

Conclusions:

• Basal cell carcinoma (BCC) can present atypically, mimicking traumatic injuries.
• A thorough ophthalmic evaluation and biopsy are crucial for accurate diagnosis of periocular lesions.
• Maintaining a high index of suspicion is vital for diagnosing periocular basal cell carcinoma (BCC).