Basosquamous carcinoma in a rural patient. Medical photograph.

Abstract

The patient is a 61-year-old male who presented to the Clínica Popular II Tía Juana with a chronic skin lesion involving the preauricular region, the auricle, and the left earlobe, with a two-year evolution. An excisional biopsy was performed on the affected areas, revealing a malignant epithelial neoplasm: invasive and ulcerated basosquamous carcinoma (BSC). This is a rare and aggressive variant of non-melanoma skin cancer that poses a significant diagnostic challenge for both clinicians and pathologists. It typically develops in sun-exposed areas, such as the face, neck, and ears, and is characterized by a high rate of local invasiveness, a marked tendency for recurrence, and increased metastatic potential compared to pure basal cell carcinomas [1,2]. Currently, the gold standard for the management of basosquamous carcinoma is Mohs micrographic surgery, often followed by adjuvant radiotherapy in cases with high-risk features [3].