An elderly man has a pearly nodule with telangiectatic vessels and central ulceration with rolled edges at the medial canthus of his lower eyelid. The MOST important reason this lesion requires early complete excision is its:
- A Tendency for early widespread hematogenous metastasis
- B Capacity for local invasion into the orbit and intracranial structures ✓
- C Uniform response to cryotherapy making surgery unnecessary
- D High rate of transformation into squamous cell carcinoma
Correct answer: B. Capacity for local invasion into the orbit and intracranial structures
Explanation
This is noduloulcerative basal cell carcinoma, the most common malignant eyelid tumor. Although it virtually never metastasises, it relentlessly invades locally, and lesions near the medial canthus can extend along the periosteum into the orbit, sinuses, and cranial cavity, producing so-called 'rodent ulcer'. Transformation to squamous cell carcinoma is not a recognized behavior, and cryotherapy alone is inadequate for medial canthal lesions.
Reference: Parsons' Diseases of the Eye, 22nd ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.