Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy.
Dermatology Unit, Department of Systems Medicine, University of Rome Tor Vergata, Italy.
Skin Res Technol. 2020 Nov;26(6):867-875. doi: 10.1111/srt.12888. Epub 2020 Jun 25.
Nail tumors often pose a significant challenge for the clinician, as they are burdened by a high delay in diagnosis and paucity of clinical signs in the early stage. In most cases, the onset of pain or nail plate dystrophy leads to imaging investigations such as plain radiography, magnetic resonance imaging, and ultrasonography (US) when surgery is pending.
A 2-year monocentric study evaluated the histologically confirmed cases of subungual glomus tumor (GT) and squamous cell carcinoma (SCC) with a pre-surgical US assessment, and reviewed their sonography features. A total of 7 digital GTs and 6 SCCs of the nail were collected.
GT and SCC are easily distinguishable on US. Compared to SCC, GT was positively associated with an ovoid shape, well-defined borders, bone cup-scalloping without cortical erosion, and a rich intralesional vascular pattern (P < 0.05). Vice versa, SCC was significantly correlated with irregular shape, ill-circumscribed margins, an infiltrative growth pattern with peripheral hypoechoic foci, posterior acoustic shadow, cortical erosion, and a highly vascular multipolar peripheral pattern (P < 0.05).
The rapid assessment of GT and SCC sonographic features may contribute to reduce diagnostic delay, expedite management, and decrease the risk of surgical relapse.
指甲肿瘤常常给临床医生带来很大的挑战，因为它们存在诊断延迟高和早期缺乏临床体征的问题。在大多数情况下，疼痛或指甲板营养不良的出现会导致影像学检查，如平片、磁共振成像和超声检查（US），在手术前进行。
一项为期 2 年的单中心研究评估了经组织学证实的甲下血管球瘤（GT）和鳞状细胞癌（SCC）的病例，这些病例在术前进行了 US 评估，并回顾了它们的超声特征。共收集了 7 例甲下 GT 和 6 例 SCC。
GT 和 SCC 在 US 上很容易区分。与 SCC 相比，GT 与卵圆形、边界清晰、无皮质侵蚀的骨杯状凹陷和丰富的瘤内血管模式相关（P<0.05）。相反，SCC 与不规则形状、边界不清、浸润性生长模式伴周围低回声灶、后方声影、皮质侵蚀和高度血管化多极周围模式显著相关（P<0.05）。
快速评估 GT 和 SCC 的超声特征可能有助于减少诊断延迟，加快管理，并降低手术复发的风险。
