A 60-year-old farmer presents with a slowly growing, pearly nodule on the lower eyelid margin with central ulceration and rolled edges, telangiectatic vessels on the surface, and loss of eyelashes. The lesion does not involve the tarsal plate. What is the most likely diagnosis?

• A Malignant melanoma
• B Sebaceous gland carcinoma
• C Squamous cell carcinoma
• D Basal cell carcinoma ✓

Explanation

Basal cell carcinoma is the most common malignant eyelid tumor, typically presenting as a pearly, umbilicated nodule with rolled telangiectatic borders and central ulceration (rodent ulcer) with lash loss. It occurs predominantly on the lower lid in sun-exposed individuals. Sebaceous gland carcinoma masquerades as recurrent chalazion and arises from meibomian glands within the tarsal plate, not the lid margin. Squamous cell carcinoma is rarer and more aggressive with a scaly, erythematous surface.

Reference: Kanski's Clinical Ophthalmology, 9th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.