Basal cell carcinoma with fibroepithelioma-like histology in a healthy child: report and review of the literature.

We report the case of a 13-year-old girl with a 7 mm plaque on the trunk. The mother of the patient reported that the lesion developed at the age of 3 and it was characterized by a slow growth. In 2003 a dermoscopic examination was executed and a diagnosis of dermical nevus was made. On examination at our department, a red-pinkish plaque with two small areas of ulceration was found on the anterior part of the trunk. At dermoscopic examination we observed vascular pattern with linear-irregular vessels, multiple blue-gray dots, blue-gray ovoid nests, and ulceration. A diagnosis of basal cell carcinoma was made and confirmed by histopathologic examination. The histopathologic specimen showed nests or lobules of basalioid cells associated with a surrounding loose fibromucinous stroma; two patterns were observed: adenoid-cystic and fibroepithelial. Some fibroepithelioma of Pinkus-like areas were present, where the fibrovascular stroma was very abundant with an arborizing network of long, thin cords of basaliod cells that extended downward from the epidermis and created a fenestrating pattern. The lesion was surgically excised. Basal cell carcinoma occurs rarely in children and is most often associated with an underlying condition that predisposes patients to the development of malignancy that was not present in our case.