Subungual Squamous Cell Carcinoma Masquerading as an Onychomycosis

Abstract

ÖzetTırnağın tümörleri iyi veya habis nitelikte olabilir. Tırnağa ait tümörlerin değişik histolojik tipleri literatürlerde rapor edilmiştir. Tırnağın yassı epitel hücreli karsinomu oldukça nadirdir ve yanlış tanı konulmaktadır. Bu nedenle bu tümörün insidansını belirlemek oldukça güçtür. Biz bu olgu sunumunda yanlış tanı konulan ve bu yüzden tedavide gecikmeye neden olan tırnağın yassı epitel hücreli karsinomunu sunmayı hedefledik. Tırnak lezyonları, tedavide gecikmeye neden olmamak için dikkatlice incelenmeli ve gerekirse bu lezyonlar histopatolojik olarak incelenmelidir. Histopatolojik tanıya göre uygun tedavi planlanmalıdır. Anahtar KelimelerOnikomikoz; Yassı Epitel Hücreli Karsinoma; Tırnak Yatağı Tümörleri Abstract Tumors of nail unit may be benign or malign. Different histological variants of subungual tumours have been reported. Subungual squamous cell carcinoma is rare, and the disease is often misdiagnosed as a benign condition, therefore it is difficult to estimate the real incidence of this disease. We hereby present a case of subungual squamous cell carcinoma that has previously been treated as leading to a delay in diagnosis and treatment. For this reason, the nail unit changes should be examined carefully and the diagnosis should be done with the histopathological examinations. Proper treatment should be planned according to the histopathological diagnosis.

Subungual Squamous Cell Carcinoma of the Third Finger with Radiologic and Histopathologic Findings: A Report of Case

“…None of the imaging modalities offer a definitive diagnosis for these differentials. Therefore, the patients are often misdiagnosed leading to an average delay of 4 years in definitive treatment noted in the literature [1]. In our case, mild pain and intermittent discharge were the symptoms and the definitive diagnosis took approximately 1 year.…”

“…Subungual SCC can arise from nail bed, nail matrix, nail groove or lateral folds [1]. The true incidence of the subungual SCC is unknown due to its rare occurrence.…”

“…Nodularity, bleeding, ulceration, large exophytic mass, lack of antifungal or antibacterial treatment response are very suspicious. In particular, rapidly growing ulcerative lesions should strongly be considered for malignancy of the subungual region, especially the SCC [1].…”

“…Although subungual squamous cell carcinoma (SCC) is a rare entity, it is the most common malignancy of the nail bed [1]. It is seen in men more often than women, and usually occurs in the fifth decade of life.…”

“…The subungual area is densely packed with connective tissues, vessels and nerves measuring 1-2 mm in thickness [3]. Approximately, 50 % of nail disorders are fungal infections [1] whereas the remainder consists of benign solid or cystic lesions and malignant neoplasms [3]. They may mimic each other causing a similar clinical picture.…”