Basal Cell Carcinoma — RACP Adult Medicine MCQ

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EasyGastroenterologyBasal Cell CarcinomaRACP Adult Medicine

A 75-year-old man with extensive sun exposure presents with a pearly papule with rolled edges and central ulceration (rodent ulcer) on the nose. Telangiectasiae are visible. It has been slowly growing over 12 months. What is the most likely diagnosis?

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Correct answer: B — Basal cell carcinoma

A pearly papule with rolled edges, central ulceration, and telangiectasiae on a sun-exposed site in an elderly person is classic for nodular BCC. It is the most common skin cancer. BCC is locally invasive but rarely metastasises. Treatment options include surgical excision (with 3–5 mm margins), Mohs surgery for high-risk sites (nose, eyelid), or curettage and cautery for superficial BCC.

Reference: Cancer Council Australia – 2024 – Skin Cancer Guidelines