Squamous cell carcinoma of the nail bed: A case report
Squamous cell carcinoma of the nail bed: A case report
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甲床鳞状细胞癌：一例报告
DOI：
10.12998/wjcc.v7.i21.3590
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发表时间：
2019-11
影响因子：
1.1
通讯作者：
Lu Hui
中科院分区：
文献类型：
--
作者：
Li Peng-Fei;Zhu Ning;Lu Hui
研究背景甲床鳞状细胞癌(SCC)是一种鲜见报道的甲下恶性肿瘤。由于它没有特殊的症状和体征，经常被皮肤科医生或外科医生误诊。延误诊断和/或错误的治疗可能会增加疾病进展的可能性。因此，需要新的视角来帮助皮肤科医生和外科医生诊断和治疗鳞状细胞癌。这一罕见病例的诊断延迟了两年，这给我们上了宝贵的一课。病例摘要：患者女，62岁，右中指甲床甲底长不愈，长达2年之久。首先，患者自己用碘治疗皮损，没有任何缓解。20个月后，一名皮肤科医生诊断出这种皮损为甲旁症，并反复进行指甲撕脱治疗，但没有明显的缓解。病变切除证实为鳞状细胞癌。随后进行了肿瘤的扩大切除和远端指间关节的截肢。前哨淋巴结活检结果为阴性。由于术前正电子发射断层扫描-计算机断层扫描的结果，腋窝淋巴结清扫被认为是可有可无的，因此跳过了清扫。术后2年随访，患者恢复快，无复发迹象。结论本病例的成功诊断和治疗强调了对甲床长期不可愈合的病变给予额外关注的必要性，以及谨慎评估和定制手术干预的必要性。
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.
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DOI：
10.1111/j.1524-4725.1992.tb02006.x
发表时间：
1992-08
期刊：
The Journal of dermatologic surgery and oncology
影响因子：
--
作者：
D. Goldminz;R. Bennett
通讯作者：
D. Goldminz;R. Bennett
影响因子：
--
作者：
Tambe SA;Patil PD;Saple DG;Kulkarni UY
通讯作者：
Kulkarni UY
影响因子：
13.8
作者：
Que, Syril Keena T.;Zwald, Fiona O.;Schmults, Chrysalyne D.
通讯作者：
Schmults, Chrysalyne D.
DOI：
10.1016/s0363-5023(76)80002-0
发表时间：
1976-09
期刊：
The Journal of hand surgery
影响因子：
--
作者：
R. E. Carroll
通讯作者：
R. E. Carroll
影响因子：
3.6
作者：
Rudolph, Ross;Zelac, Daniel E.
通讯作者：
Zelac, Daniel E.