Tuesday, January 31, 2006

Difficult BCC

On January 30, 2006, this 49 yo woman presented with a somewhat sclerotic plaque on the blub of the nose. By history, this has been present for 1.5 years. A 2 mm punch biopsy was taken at the site marked X.

If this turns out to be BCC, I will refer for micrographic surgery. Does anyone feel radiotherapy is appropriate for a patient of this age?

First Biopsy showed no evedence of BCC or malignancy. Repeat biopsy taken. Here is another clinical photo:


  1. Clinically, morpheaform BCC is most likely. At our centre, Mohs surgery would be the standard of care for this patient if the biopsy confirms this. There are at least 3 independent indications for Mohs: histology, location, size (appears > 2 cm). We use radiotherapy mostly as a palliative modality.
    Thanks for posting,

  2. If histology turns out to be a BCC, I would refer to a dermatologic surgeon for Mohs Surgery. Tom Rohrer MD (Chestnut Hill)is a great guy in Mohs Surgery.



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