Partially Pigmented Eyelid Basal Cell Carcinoma With Unusual Trabecular Histologic Pattern

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A 61-year-old woman noted a pigmented lesion of the right upper eyelid to be present for 9 years (Fig. A). Clinical diagnosis was pigmented basal cell carcinoma. Histopathology showed a well-circumscribed tumor consisting mostly of linear ribbons of basaloid cells in a trabecular or zebra-like pattern within a myxoid stroma. Focal clumps of melanin pigment were present superficially. Tumor cells stained positively with the BerEP4 immunostain (Figs. B-D).
Basal cell carcinoma presents with variable histologic patterns but usually show the solid, adenoid, or morpheifom configuration in the eyelid. Unusual histologic variants of basal cell carcinoma may be diagnostically challenging. The trabecular “striped” pattern of the current case is rare and may also be present in Merkel cell and trichilemmal carcinomas.

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