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.
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
