Basal Cell Carcinoma Mimicking Dermatofibrosarcoma Protuberans: Case Report

Introduction: Basal cell carcinoma (BCC) is the most common type of carcinoma worldwide. BCC development is the result of a complex interaction between environmental, phenotypic and genetic factors. Presentation is highly heterogeneous, presenting from superficial or nodular lesions with a good prognosis to very extensive lesions in atypical locations clinically and radiologically mimicking other tumors. Case presentation: We present the case of a 34-year-old man with no past medical history, with an asymptomatic nodule that was increasing in size on the right thigh. High-frequency ultrasonography (HFUS) evaluation revealed an oval-shaped lesion with mixed echogenicity and posterior enhancement, with Doppler showing increased vascularization. A biopsy of the lesion was performed with suspicion of dermatofibrosarcoma protuberans, reporting unexpectedly an infiltrative basal cell carcinoma. The tumor was excised with free margins in the final pathology report. Conclusions: HFUS is an increasingly utilized tool that can accompany the study of a malignant lesion. Further studies are required to define more specific criteria for different skin tumors, always in conjunction with histology.