Squamous cell carcinoma of the nail bed: A case report  

作　　者：Peng-Fei Li Ning Zhu Hui Lu 

机构地区：[1]Department of Plastic and Aesthetic Center,The First Affiliated Hospital,School of Medicine,Zhejiang University,Hangzhou 310000,Zhejiang Province,China [2]Department of Ophthalmology,The First Affiliated Hospital,School of Medicine,Zhejiang University,Hangzhou 310000,Zhejiang Province,China [3]Department of Orthopedics,The First Affiliated Hospital,School of Medicine,Zhejiang University,Hangzhou 310000,Zhejiang Province,China

出　　处：《World Journal of Clinical Cases》2019年第21期3590-3594,共5页世界临床病例杂志

基　　金：Supported by the National Natural Science Foundation of China,No.81702135;Zhejiang Medical Association Clinical Scientific Research Program,No.2013ZYCA19 and 2015ZYC-A12;Zhejiang Medicine and Hygiene Research Program,No.2016KYB101 and 2015KYA100;Zhejiang Traditional Chinese Medicine Research Program,No.2016ZA124 and 2017ZB057

摘　　要：BACKGROUND Squamous cell carcinoma(SCC)of the nail bed is a poorly reported malignant subungual tumor.Because it presents with nonspecific symptoms and signs,it is frequently misdiagnosed by dermatologists or surgeons.A delay in diagnosis and/or wrong treatment might increase the possibility of disease progression.Thus,new perspectives are needed to assist dermatologists and surgeons with diagnosing and treating SCC.This rare case presented with a 2-year delay in the diagnosis of SCC teaches a valuable lesson.CASE SUMMARY A 62-year-old female presented with a non-healing subungual growth in the nail bed of the right middle finger for 2 years.The lesion was first medicated with iodine by the patient herself without any relief.Twenty months later,a dermatologist diagnosed the lesion as paronychia and treated it with nail avulsions repeatedly with no obvious alleviation.A lesionectomy confirmed the lesion was SCC.An extended excision of the tumor with amputation of the distal interphalangeal joint was subsequently performed.A biopsy of sentinel lymph nodes was negative.Due to the result of preoperative positron emission tomography-computed tomography scanning,sweeping of axillary lymph nodes was considered dispensable and was skipped.At the 2-year follow-up,the patient showed a quick recovery and no sign of recurrence.CONCLUSION Our successful diagnosis and treatment of the case highlights the need for additional attention to long-standing non-healing lesions of the nail bed and the necessity for discreet evaluation and customization of surgical interventions.BACKGROUND Squamous cell carcinoma(SCC) of the nail bed is a poorly reported malignant subungual tumor.Because it presents with nonspecific symptoms and signs, it is frequently misdiagnosed by dermatologists or surgeons.A delay in diagnosis and/or wrong treatment might increase the possibility of disease progression.Thus, new perspectives are needed to assist dermatologists and surgeons with diagnosing and treating SCC.This rare case presented with a 2-year delay in the diagnosis of SCC teaches a valuable lesson.CASE SUMMARY A 62-year-old female presented with a non-healing subungual growth in the nail bed of the right middle finger for 2 years.The lesion was first medicated with iodine by the patient herself without any relief.Twenty months later, a dermatologist diagnosed the lesion as paronychia and treated it with nail avulsions repeatedly with no obvious alleviation.A lesionectomy confirmed the lesion was SCC.An extended excision of the tumor with amputation of the distal interphalangeal joint was subsequently performed.A biopsy of sentinel lymph nodes was negative.Due to the result of preoperative positron emission tomography-computed tomography scanning, sweeping of axillary lymph nodes was considered dispensable and was skipped.At the 2-year follow-up, the patient showed a quick recovery and no sign of recurrence.CONCLUSION Our successful diagnosis and treatment of the case highlights the need for additional attention to long-standing non-healing lesions of the nail bed and the necessity for discreet evaluation and customization of surgical interventions.

关 键 词：SQUAMOUS cell carcinoma NAIL BED LESION Customized treatment MALIGNANT SUBUNGUAL tumor Case report 

分 类 号：R73[医药卫生—肿瘤]