Pigmented basal cell carcinoma of the eyelid

Purpose While Basal cell carcinoma (BCC) is the most common malignant lesion of the eyelid, pigmented basal cell carcinoma of the eyelid are only rarely seen. Thus it is usually misdiagnosed clinically. The purpose of this presentation is to describe three cases with pigmented periocular BCC and to discuss its clinical and histopathological characteristics. Methods A retrospective review was performed, of the files and the histopathologic slides of patients with pigmented BCC of the eyelid, who were treated in the Goldschleger Eye Institute, Sheba Medical Center, Tel Hashomer, Israel, during 2007‐2012. Results Fifty three patients were found with eyelid BCC diagnosed between 2007 and 2012, and three of them had pigmented BCC. Two of the tumors were on the lower lid and one in the medial canthus. All were uniformly or almost uniformly darkly pigmented. All were nodular and treated by complete surgical excision. The clinical diagnosis of two of the lesions was nevus. Conclusion Pigmented BCC should be remembered among the differential diagnosis of pigmented lesions of the eyelid. It is interesting that our cases of pigmented BCC such as other cases described in the literature, were nodular or nodulo‐ulcerative and not cystic or sclerosing types.