Clear cell basal cell carcinoma. Given the never ending stream of basal cell carcinomas my eyeballs see, it is surprising to me how rarely I seen this variant of basal cell carcinoma. The nests of tumor cells show prominent clear cell change with an adamantinoid appearance. Usually, I will see clear cell basal cell carcinoma focally within a more typical basal cell carcinoma, but this tumor showed only clear change. A sebaceous neoplasm may be a consideration in this case, but the cytoplasm lacks the vacuolization and nuclear scalloping of sebaceous differentiation.