甲单位骨侵袭性无色素性黑素瘤1例罕见病例。
A Rare Case of Osteoinvasive Amelanotic Melanoma of the Nail Unit.
作者信息
Black Alexandra T, Lahouti Arash H, Genco Iskender S, Yagudayev Matvey, Markinson Bryan C, Spielfogel William D
机构信息
Department of Orthopedics, Lenox Hill Hospital Northwell, New York, New York, USA.
Department of Pathology, Lenox Hill Hospital Northwell, New York, New York, USA.
出版信息
Skin Appendage Disord. 2021 Feb;7(2):139-143. doi: 10.1159/000512331. Epub 2020 Dec 23.
INTRODUCTION
Amelanotic melanoma is a rare subtype, which may be clinically difficult to diagnose due to lack of pigmentation and variable histopathological features. Osteoinvasion is another rare characteristic of melanoma. There are few reports in the literature of amelanotic melanoma of the nail unit (nail bed, matrix, and nail folds) with invasion of bone.
CASE PRESENTATION
We present a case of a 73-year-old Caucasian male with a 13-month history of an ungual lesion on his right hallux. The lesion was initially treated as a chronic diabetic ulceration with failure to resolve with standard of care.
DISCUSSION/CONCLUSION: A heightened index of suspicion for a malignant process is necessary when standard of care fails to lead to improvement or resolution. In these instances, biopsy should be seriously considered.
引言
无色素性黑色素瘤是一种罕见的亚型，由于缺乏色素沉着和组织病理学特征多变，临床上可能难以诊断。骨侵袭是黑色素瘤的另一个罕见特征。关于甲单位（甲床、甲母质和甲襞）无色素性黑色素瘤伴骨侵袭的文献报道很少。
病例介绍
我们报告一例73岁的白种男性，其右拇趾有一个甲部病变，病程13个月。该病变最初被当作慢性糖尿病溃疡治疗，按护理标准治疗未愈。
讨论/结论：当护理标准未能使病情改善或缓解时，必须提高对恶性病变的怀疑指数。在这些情况下，应认真考虑进行活检。
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