basal cell carcinoma ( bcc ) is one of the common malignant cutaneous neoplasms seen in the elderly . nodular basal carcinoma is a more frequently seen variant , whereas fibroepithelioma of pinkus is rare . clinical examination revealed a single nodule of size 3 cm  4 cm on the lateral part of abdomen . it was dome - shaped in appearance and had surface telangiectasia [ figure 1 ] . nodule with pigmented beaded border and central dome - shaped , pinkish area on the lateral part of abdomen a biopsy from the nodule showed two different histological patterns , nodular at one half and anastomosing pattern at the other half [ figure 2 ] . both the tumor patterns were connected with the surface epidermis and also with one another . nodular masses were made up of basaloid cells with peripheral palisade , and cleft was noted between the tumor islands and the stroma [ figure 3 ] . , cords and columns of basaloid cells were seen forming reticulated network . at places peripheral palisading , melanin pigment , and follicular germ - like structures protruding were seen [ figure 4 ] . thus the histopathological and clinical features were suggestive of nodular bcc in continuity with fibroepithelioma of pinkus . masses of basaloid cells ( left half ) and cords and columns of basaloid cells forming reticulated pattern ( right half ) , ( h and e , 100 ) aggregations of basaloid cells with palisading at the periphery , cleft formation , and melanin pigment deposition is also seen ( h and e , 200 ) cords and columns of basaloid cells with peripheral palisading . nodular bcc is the commonest variant of bcc that presents as pearly or pigmented papule or nodule with rolled out border with or without ulceration on the sun - exposed parts . nodular bcc histologically shows tumor masses made up of basaloid cells having peripheral palisading and cleft between the surrounding stroma and the tumor islands . it is considered as a rare variant of bcc with distinct clinical and histopathological features . it presents as skin - colored to pink sessile or pedunculated papule or nodule on the trunk often resembling a fibroma . it is commonly reported to occur in adult males aged 4060 years . however , a few cases in pediatric population have been reported . it consists of basaloid cells arranged in cords and columns , which anastomose with each other . many of the cords and columns show connections with the surface epidermis . apart from cases of nodular bcc with fibroepithelioma of pinkus , other histological variants of bcc - like adenoid - cystic bcc and keratotic bcc has been described with fibroepithelioma of pinkus . fibroepithelioma of pinkus is considered as an unusual variant of bcc by some authors , whereas others consider it to be a benign analogue of bcc . presence of fibroepithelioma of pinkus in continuity with nodular bcc in this case supports its malignant nature .
fibroepithelioma of pinkus and nodular basal cell carcinoma ( bcc ) are different morphological variants of bcc . 
 it is very rare to see both the variants together in a single lesion . 
 here we report a case of a 56-year - old female who presented with a nodule on the trunk , which on biopsy showed features of both nodular bcc and fibroepithelioma of pinkus .