Basal Cell Carcinoma — SCE Dermatology MCQ

Instant feedback + full explanation. One question, done properly.

HardSkin CancerBasal Cell CarcinomaSCE Dermatology

A 65-year-old man with BCC on the scalp has histology showing basaloid islands with peripheral palisading in a fibrotic stroma. The tumour has an infiltrative growth pattern with thin irregular strands and spiky clusters extending into the dermis. What BCC subtype carries the highest recurrence risk after standard excision?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: B — Infiltrative/morphoeic

Infiltrative/morphoeic basal cell carcinoma is the high-risk subtype described by thin, irregular strands or spiky nests of basaloid tumour infiltrating a dense fibrotic or sclerotic stroma. This growth pattern produces poorly defined clinical and histological margins with subclinical extension, so standard excision has a higher risk of incomplete clearance and recurrence than well-circumscribed nodular, superficial or pigmented BCC. Basosquamous BCC is also regarded as aggressive, but the histology in the stem is classic for infiltrative/morphoeic BCC, which is the best answer.

Reference: British Association of Dermatologists. Guidelines for the management of adults with basal cell carcinoma, 2021. https://academic.oup.com/bjd/article/185/5/899/6599942