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Clinical Problem Solving: Pathology
January 2002

Pathology Quiz Case 1

Author Affiliations
 

FREDERIC B.ASKINMDWILLIAM H.WESTRAMD

Arch Otolaryngol Head Neck Surg. 2002;128(1):75. doi:10.1001/archotol.128.1.75

A 53-YEAR-OLD man presented with recurrent basal cell carcinoma (BCC) in his left infraorbital region. Seven years earlier, he had undergone 3 Mohs excisions of a keratotic facial BCC. His medical history also included B-cell small lymphocytic lymphoma with abdominal and spinal involvement. Treatment for the lymphoma involved surgical debridement of the lower thoracolumbar spine as well as ongoing chemotherapy for the past 10 years for a waxing and waning course. At the time of presentation, the patient still had residual BCC in the infraorbital region. Examination revealed a firm, indurated 1 × 1.5-cm left infraorbital lesion adhering to surrounding tissues, without involvement of the lateral nasal wall. The results of the rest of the head and neck examination were normal. A computed tomographic scan showed no bony involvement. The patient then underwent an extensive excision with cervicofacial advancement flap reconstruction. A micrograph of the infraorbital specimen is shown in Figure 1.

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