Subungual osteochondroma. Differential diagnosis and treatment

Abstract

Subungual osteochondroma, a rare disorder of the fingers and toes, occurred in five patients. Clinical features of the condition include nail deformation, history of long, slow growth, and characteristic radiologic features. Surgery is directed toward total tumor resection with preservation of the nailbed to achieve normal nail growth. Differential diagnosis included bony, cartilagionous, and soft tissue tumors as well as cystic lesions. Malignant tumor should be suspected by not confused with this benign disorder. Roentgenologic examination is indicated in the differential clinical diagnosis of any subungual mass.

Subungual Osteochondroma: Clinical and Radiologic Features and Treatment

“…1 Its radiologic features are often pathognomonic, being composed of cortical and trabecular bone with an overlying hyaline cartilage cap that must demonstrate continuity with the underlying parent bone cortex and medullary canal. 1,3,4 Osteochondroma is a benign osteocartilaginous outgrowth affecting bones with enchondral growth such as large bones, arising adjacent to the cortex and next to the metaphysis. 2 In very few cases this tumor affects small bones, localizing to the distal phalanx and producing deformity of the overlying nail.…”

Subungual Osteochondroma: A Case Report

“…Although they are thought to be congenital in origin, they usually remain asymptomatic in childhood and begin enlarging after puberty. 3 They are frequently seen in patients between 10 and 25 years old. Clinically the lesions appear as firm, shiny, smooth-surfaced, whiteyellow nodules, which is characteristic for the entity.…”

“…Benign lesions such as verruca vulgaris, subungual fibroma, glomus tumor, pyogenic granuloma, subungual digital mucous cyst, subungual exositosis and enchondroma, and malignant lesions such as osteosarcoma, squamous cell carcinoma, and malignant melanoma are included in the differential diagnosis. 3 Verruca vulgaris, squamous cell carcinoma, and malignant melanoma can be easily diagnosed by histopatho-S. Bostanci, MD, P. Ekmekçi, MD, C. Ekinci, MD, B. Akçaboy, MD, and E. Gürgey, MD have indicated no significant interest with commercial supporters. Address correspondence and reprint requests to: Pelin Ekmekçi, MD, Ankara Üniversitesi Tip Fakültesi, Dermatoloji Anabilim Dali, 06100 Sihhiye, Ankara, Turkey.…”

“…Radiologically they may be seen as radiolucent areas surrounded by a calcified cartilage localized on the dorsum of the expanded phalanx. 3,5 Osteoid osteomas, which are very rare in subungual locations, have characteristic night pains that are dramatically relieved by salicylates. Also on radiologic examination, in contrast to osteochondromas, they are seen as nodular lesions surrounded by a sclerotic zone.…”

A Case of Subungual Osteochondroma

“…Although osteochondromas are the most common benign tumors of bone, only a few cases have been reported on the subungual locations of fingers and toes (1). It is very important to differentiate subungual osteochondroma from smilar tumors of subunguallocations.…”