A 62-year-old farmer presents with a slowly growing, painless nodule on the lower eyelid margin for 8 months. Examination reveals a pearly, well-defined lesion with rolled edges, telangiectasia, and central ulceration. The MOST likely diagnosis is:

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

Explanation

Basal cell carcinoma is the most common malignant eyelid tumor, accounting for approximately 90% of eyelid malignancies. The classic presentation is a pearly nodule with rolled edges, telangiectasia, and central ulceration (rodent ulcer). It occurs predominantly on the lower eyelid in elderly individuals with chronic sun exposure. Sebaceous gland carcinoma presents as a diffuse, firm, yellowish lesion that mimics chalazion.

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

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.