Carcinoma In Disguise-Atypical Presentation of Squamous Cell Carcinoma

Nail Lesion with High Index of Suspicision Needs To Be Biopsied For Early Diagnosis And Definitive Treatment

Authors

  • Kawari Sowbhagyalaxmi Ramesh Department of General Surgery, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education (MAHE), Manipal, Karnataka, India
  • Abhishek Ganguly Department of General Surgery, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education (MAHE), Manipal, Karnataka, India
  • Abhijith Acharya Department of General Surgery, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education (MAHE), Manipal, Karnataka, India
  • Manohar V Pai Department of General Surgery, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education (MAHE), Manipal, Karnataka, India

Keywords:

Squamous cell carcinoma, nail bed, onychomycosis

Abstract

Squamous cell carcinoma (SCC) of the nail unit is a rare malignant subungual tumour.Often there is a delay in diagnosis and treatment as it can be often misdiagnosed as a chronic paronychia, onychomycosis, pyogenic granuloma, subungual wart, glomus tumour.
Here we are presenting a case of an elderly male was brought to the out-patient department with deformed appearance of the right fourth finger of hand from one year. With a preceding history of trauma and two sessions of excision of nail of the finger was  showing onychomycosis, he was admitted for further evaluation. Imaging in form of Xray of the hand and MRI of the finger showed bony destruction of middle and distal phalanges, favouring fungal osteomyelitis. However incisional biopsy  from the nail unit revealed suspicious of squamous cell carcinoma. Multimodal approach to the tumor is required ,however surgical excision is the definitive treatment .

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Published

09.01.2025