The correct answer is A. Microcystic adnexal carcinoma.
One of the most common locations for MAC includes the perioral area. Histologically it presents with poorly demarcated tumor cells invading the dermal and subcutaneous tissue. Islands of basaloid keratinocytes, horn cysts and duct structures are also seen within a desmoplastic stroma.
The remaining answer choices have different clinico-pathologic findings than what is seen in the image and described in the question stem.