Metastatic Tumors to the Nail Unit: Subungual Metastases

Cohen, Philip R.

doi:10.1111/j.1524-4725.2001.01913.x

Cited by 46 publications

(32 citation statements)

References 91 publications

(426 reference statements)

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“…Although subungual metastasis from a malignant lung tumor is rare [9], in 44% of these patients, this lesion has been reported as the presenting feature of an otherwise occult tumor [3]. The diagnosis of subungual metastasis is rarely entertained and typically misdiagnosed as a benign lesion.…”

Section: Case Reportmentioning

confidence: 98%

First Presentation of Lung Adenocarcinoma as a Subungual Metastasis

Seth

Athanassopoulos

Mir

2007

Hand (New York, N,Y.)

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Section: Case Reportmentioning

confidence: 98%

First Presentation of Lung Adenocarcinoma as a Subungual Metastasis

Seth

Athanassopoulos

Mir

2007

Hand (New York, N,Y.)

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“…Mean survival after diagnosis of metastatic skin lesions is reported as 4 months. [6][7][8] Our patient survived 3 years after recognition of the finger metastasis.…”

Section: Discussionmentioning

confidence: 92%

“…3 The hand region has been reported as There have been approximately 100 instances of digital skin metastases reported in the literature. 5,6 The prominent histopathologic finding of squamous cell carcinomas metastasized to the skin has been reported as a tumoral pathology located in the dermis, with or without subcutaneous fat tissue involvement. The epidermal layer has been observed as being devoid of tumoral cell invasion.…”

Section: Discussionmentioning

confidence: 99%

Three Years' Survival after Diagnosis of Finger Metastasis from End-Stage Lung Cancer

Bahar

Borman

Ertaş

et al. 2008

Dermatologic Surgery

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The authors have indicated no significant interest with commercial supporters.T here are cases in the literature presenting digital skin metastasis from a primary cancer. The majority of primary foci are reported as being lung carcinomas (40%). 1,2 We present a patient having finger metastasis from end-stage squamous cell carcinoma of the lung that had already metastasized to the brain and liver. The unusual point about our case was 3 years' survival of the patient after detection of digital skin metastasis and amputation of the finger, which is a remarkable finding, compared to similar cases in the literature. Case ReportA 68-year-old woman presented to our clinic with rapid swelling of her fingertip that had occurred within the previous month. She mentioned that the lesion had begun as a painful, purple nodule at her nail bed and had progressed rapidly. Three months earlier, inoperable Stage IV, T 4 N 0 M 2 , low-differentiated squamous cell carcinoma of the right lung had been diagnosed, which had metastasized to the brain and liver. She had received chemotherapy and radiotherapy. Results of a physical examination showed a 3-cm hemorrhagic, vegetative mass that invaded the subungual and pulp regions of the third finger of the right hand (Figure 1).Results of a punch biopsy were consistent with a desmoplastic reaction of the carcinoma at the stroma. The tumor cells were found to be atypical epithelial cells having hyperchromatic nuclei, pleomorphism, prominent mitotic activity, and eosinophilic cytoplasm.These findings were consistent with a diagnosis of low-differentiated squamous cell carcinoma. We amputated the finger at the level between the proximal and middle phalanges and repaired the stump primarily. Pathologic examination of the specimen showed that the epidermal and the dermal layers were devoid of the pathology, whereas the deep dermis had been totally infiltrated by the tumor cells. These findings were consistent with a diagnosis of metastasis of low-differentiated squamous cell carcinoma of the lung (Figures 2-4). The surgical margins were clear of tumoral invasion. The patient had received radiotherapy and chemotherapy earlier and had been under the planned chemotherapy protocol at that time. No additional regimen specific for the finger metastasis was planned by the medical oncology personnel. The patient died from multiorgan failure 3 years later. DiscussionLung cancers metastasize primarily to the bones. 1,2 However, approximately 0.2% of lung carcinomas have been reported to metastasize to the hand, and digital skin is an extremely unusual site. 2 Lung tumors have been reported as being the most responsible primary origin (40%) for hand, skin, and bone metastases, followed by kidney and breast tumors. 3 The hand region has been reported as

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“…The most common cause is direct extension from a bony lesion beneath the nail plate. In contrast to cutaneous metastasis, subungual metastasis may be the initial manifestation of a previously undiagnosed cancer in 44% of patients [6].…”

Section: Discussionmentioning

confidence: 99%

“…In a review of the literature, Cohen [6] reported 133 patients with subungual metastases, with the lung as the main primary tumor site (41%), followed by the kidney (11%) and breast (9%). No primary tumors of the prostate were reported in this review.…”

Section: Discussionmentioning

confidence: 99%

Subungual Metastasis of an Adenocarcinoma of the Prostate in a Finger

García-Galaviz

Domínguez‐Cherit

Caro-Sánchez

et al. 2018

Skin Appendage Disord

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Cutaneous metastasis is a rare event occurring most frequently in patients previously diagnosed with cancer. However, subungual metastases are even less frequent. The most common neoplasms associated with the latter are lung, kidney, and breast neoplasms. Lung cancer is the main cause of subungual metastases in the fingers, and genitourinary tract tumors are the main cause of subungual metastases in the toes. This is the first case report of an adenocarcinoma of the prostate with subungual metastasis.

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Metastatic Tumors to the Nail Unit: Subungual Metastases

Abstract: The clinical differential diagnosis of a new periungual or subungual lesion (with or without an associated nail plate dystrophy) should include tumor metastasis to the nail unit not only in oncology patients, but also in previously cancer-free individuals.

Cited by 46 publications

References 91 publications

First Presentation of Lung Adenocarcinoma as a Subungual Metastasis

First Presentation of Lung Adenocarcinoma as a Subungual Metastasis

Three Years' Survival after Diagnosis of Finger Metastasis from End-Stage Lung Cancer

Subungual Metastasis of an Adenocarcinoma of the Prostate in a Finger

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