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Onycholemmal carcinoma.
Makoto Inaoki1, Eiichi Makino, Maiko Adachi
1Department of Dermatology, Kawasaki Medical School, Kurashiki, Japan. inaoki-m@med.kawasaki.ac.jp
Journal of Cutaneous Pathology
|August 22, 2006
Summary
This study describes a rare case of onycholemmal carcinoma, an epithelial tumor of the nail, in a 70-year-old man. The diagnosis was confirmed through histological and immunohistochemical analysis, highlighting its unique growth patterns.
Area of Science:
- Dermatopathology
- Oncology
Background:
- Nail tumors are rare, and onycholemmal carcinoma is an uncommon malignancy arising from the nail apparatus.
- Indolent onycholysis can be a presenting symptom, necessitating thorough diagnostic evaluation.
Observation:
- A 70-year-old male presented with a 5-year history of refractory indolent onycholysis of the little finger.
- Radiographic examination ruled out bone involvement.
- Histological analysis revealed an infiltrative epithelial tumor with varying keratinocyte atypia and characteristic cystic structures.
Findings:
- The tumor exhibited lobular masses with direct transition of epithelium to amorphous keratin, lacking keratohyaline granules.
- The diagnosis of onycholemmal carcinoma was established based on these unique histological features.
- Immunohistochemistry showed a keratin profile similar to nail bed epithelium and a lower proliferation rate (Ki-67) compared to prior cases.
Implications:
- This case expands the understanding of onycholemmal carcinoma presentation and histopathology.
- Accurate diagnosis is crucial for appropriate management of this rare nail malignancy.
- Further research into the molecular characteristics and behavior of onycholemmal carcinoma is warranted.