Which lesion grows rapidly early but may spontaneously resolve, commonly described as Keratocanthoma?

• A. Basal cell carcinoma
• B. Keratocanthoma
• C. Squamous cell carcinoma
• D. Melanoma

Answer: (B)

Keratocanthoma is characterized by rapid growth in the early phase followed by potential spontaneous regression. Clinically it often looks like a dome-shaped lesion with a central keratin-filled crater, and it can enlarge quickly over weeks and then involute over months. This self-limited course helps distinguish it from other eyelid tumors that persist or progress, such as basal cell carcinoma, which grows slowly and rarely shrugs off on its own, and squamous cell carcinoma, which tends to be more aggressive and not expected to regress spontaneously. Melanoma typically presents as a pigmented lesion with irregular color and borders rather than a crateriform, keratin-filled center with possible regression. Because Keratocanthoma can resemble squamous cell carcinoma both clinically and histologically, a biopsy is often performed to confirm the diagnosis.