Basal cell carcinoma appearing to emanate from the punctum

Abstract

Purpose: To present the clinical and histological characteristics of a basal cell carcinoma, which appears to emanate from the lacrimal punctum. Observations: An 81-year-old caucasian female presented with an irritating lesion arising from the left upper punctum for approximately four months. Examination demonstrated a pedunculated pinkish lesion emerging from the left upper punctum. The patient elected to pursue the removal of the lesion. An excisional biopsy was performed by placing a curette within the upper eyelid punctum, and the lesion was scooped out. Pathology showed invasive nodular basal cell carcinoma. Following the diagnosis, a wedge resection of the left upper punctal region was performed, which showed no residual carcinoma. Conclusion and importance: This case describes a unique instance of a basal cell carcinoma clinically appearing to arise solely from the upper eyelid punctum. A level of suspicion should be maintained when excising benign-appearing eyelid lesions, and a histopathological analysis is warranted.

Keywords

• Basal cell carcinoma
• BCC
• Punctum
• Mimicking lesion