Abstract
Basal cell carcinoma is the most common skin cancer. Pigmented basal cell carcinoma is an uncommon clinical presentation that can resemble a melanoma. We present the clinical and pathologic features of three individuals whose pigmented basal cell carcinomas masqueraded as melanomas. All of the patients were Hispanic and ranged in age from 63 years to 77 years. They presented with a pigmented lesion that was ultimately diagnosed as a pigmented basal cell carcinoma; one woman had a collision tumor consisting of a pigmented basal cell carcinoma and a seborrheic keratosis. All of the patients had their tumors removed using Mohs micrographic surgery, without recurrence. The clinical differential diagnosis of a black tumor―particularly in patients with darker skin types―should include pigmented basal cell carcinoma in addition to melanoma; a biopsy of the lesion will establish the diagnosis.
Highlights
Common cutaneous malignancies include basal cell carcinoma, squamous cell carcinoma, and malignant melanoma [1,2,3]
We present the clinical and pathologic features of three individuals whose pigmented basal cell carcinomas masqueraded as melanomas
All of the patients were Hispanic and ranged in age from 63 years to 77 years. They presented with a pigmented lesion that was diagnosed as a pigmented basal cell carcinoma; one woman had a collision tumor consisting of a pigmented basal cell carcinoma and a seborrheic keratosis
Summary
Common cutaneous malignancies include basal cell carcinoma, squamous cell carcinoma, and malignant melanoma [1,2,3]. Views of the basal cell carcinoma (within the black circle) prior to biopsy, from the right side (A), frontal (B), and left side (C), of the nasal tip of a 74-year-old Hispanic woman demonstrate an ulcerated (blue arrows), black nodule (black arrows). Distant (A) and closer (B and C) views of a collision tumor consisting of a pigmented basal cell carcinoma that presented as a large ulcerated black nodule (black arrow) and a seborrheic keratosis (orange arrows) appearing as pigmented patches adjacent to the centrally located black nodule on the left breast of a 77-year-old woman. Correlation of the clinical presentation and pathology established the diagnosis of a collision tumor consisting of an ulcerated nodular basal cell carcinoma and a seborrheic keratosis. Follow-up after three months did not reveal any recurrence
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