Malignant melanoma masqueraded as ingrown toe nail

Area of Science:

• Oncology
• Dermatology
• Pathology

Background:

• Subungual melanoma is a rare malignancy.
• Early diagnosis is crucial for effective treatment and improved prognosis.

Observation:

• A 62-year-old female presented with a year of left big toe pain, initially managed as an ingrown nail.
• A black swelling was noted, and tissue biopsy revealed malignant melanoma.
• Histopathology confirmed invasive melanoma with satellite lesions, affecting the bone.

Findings:

• The patient was misdiagnosed with an ingrown toenail, delaying the identification of subungual amelanotic melanoma.
• Malignant cells exhibited characteristic features, including abundant cytoplasm and hyperchromatic nuclei.
• Amputation of the big toe was performed due to the advanced stage of the tumor.

Implications:

• This case underscores the need for vigilance in diagnosing persistent toe pain, especially when symptoms are atypical.
• It highlights the diagnostic challenges posed by amelanotic melanoma, which can mimic benign conditions.
• Raising awareness among clinicians about this rare presentation can improve patient outcomes.