The correct answer is A. Bilamellar calcification of the falx cerebri.

This photo is depicting many basal cell carcinomas and asking about the criterion to diagnose Gorlin’s or basal cell nevus syndrome. The major criteria for Gorlin’s syndrome include >2 BCCs or 1 BCC before the age of 20, odontogenic keratocysts of the jaw, >/= 3 palmar or plantar pits, bifid or fused ribs, first degree relative with Gorlin’s syndrome, and bilamellar calcification of the falx cerebri.

The minor criteria for Gorlin’s syndrome include macrocephaly, medulloblastoma, bilateral ovarian fibromas, congenital abnormalities (frontal bossing, hypertelorism, cleft lip or palate), skeletal abnormalities (Sprengel deformity, pectus deformity, syndactyly of the digits, and radiographic abnormalities. A patient must meet 2 major or 1 major and 2 minor criteria to be defined as having Gorlin’s syndrome.

References: 

Bolognia, J., Jorizzo, J. L., & Schaffer, J. V. (2012). Dermatology. Philadelphia: Elsevier Saunders.