Basal Cell Carcinoma with Adnexal Differentiation, a Rare Entity and Challenging Histopathology Presentation. Case Report

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Lizy M Paniagua Gonzalez
Ikue Shimizu


Cutaneous Malignancy, BCC, Rare histopathology


We report an 88 year-old male with a history of multiple non-melanoma skin cancers who presented for Mohs micrographic surgery with a biopsy proven infiltrative and nodular basal cell carcinoma located on the right posterior ear. During Mohs surgery, frozen sections revealed a typical nodular BCC on stage 1.   However, on stage 2, frozen section showed nodular aggregates of regular cuboidal cells with pale cytoplasm with areas mimicking multi-nucleated giant cells. Deeper permanent sections were consistent with BCC with adnexal differentiation. This histopathological presentation of basal cell carcinoma is uncommon and we sought to report the clinical and pathological features of this case. 


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