• 대한골관절종양학회지
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• 제1권2호
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• pp.244-248
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• 1995

사구종 환자 8례중 단순 절제만으로 전례에서 동통 소실과 함께 종괴 제거 후 세심한 조상 봉합을 함으로써 손톱의 변형을 최소화 할 수 있었고, 수술시 손톱을 완전히 제거하지 않고 다시 제 위치에 고정함으로써 수술후 창상치료가 간편하였으며, 환자가 조기에 손가락을 사용하는데 불편함을 최소화 할 수 있었다.

• Archives of Plastic Surgery
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• 제38권4호
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• pp.398-400
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• 2011

Purpose: Subungual tumors are a common cause of nail plate deformity, and may be caused by fibrokeratoma, Koene's tumor and glomus tumors. Neurofibromas, either as part of neurofibromatosis or as a solitary tumor are exceptionally rare in the digits. Methods: A 44-year-old man presented with painless onychodystrophy and nail plate elevation of the right thumb due to a small subungual mass that had started growing 3 years ago. Sensory evaluation of the distal phalanx was normal, and no discoloration nor infection signs were seen. The nail plate was extracted under local anesthesia, and the mass was delicately removed without injury to the nail bed. The nail matrix was repaired with primary closure. Results: Histopathology shows a well circumscribed, cellular tumor with myxoid stroma. Tumor cells were S-100 protein positive, and the patient was diagnosed with myxoid neurofibroma. There has been no sign of recurrence to date, 14 months after the operation. Conclusion: Presentation of cutaneous neurofibromas in the digits is an uncommon finding. They may occur as a manifestation of neurofibromatosis or as a solitary tumor. Subungual neurofibromas are exceptionally rare. To our knowledge, there are only ten reports of solitary subungual neurofibroma unrelated to neurofibromatosis to date. We report a rare case of solitary subungual myxoid neurofibroma of the thumb, that was treated through total excision, with preservation of the nail matrix.

• Archives of Plastic Surgery
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• 제36권1호
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• pp.101-104
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• 2009

Purpose: Subungual squamous cell carcinoma is a very rare malignant tumor of the digitus especially in toe making it very difficult to differentiate with tinea unguium, verruca vulgaris, eczema, pyogenic granuloma, and malignant melanoma due to their clinical similarities. Therefore this article reports on subungual squamous cell carcinoma of left 5th toe. Methods: A patient visited at our hospital due to pain and incurable inflammation on left 5th toe with no improvement for four months. Despite of antibiotics and dressing for a week, treatment was ineffective. After excisional biopsy, he was diagnosed with subungual squamous cell carcinoma. And ray amputation and prophylactic inguinal lymph node dissection was done. Results: The biopsy was showed irregular cells made up of anaplastic and squamous cells in the dermis and epidermis. And the inguinal lymph node showed no metastatsis. The patient had been treated without significant complications and recurrence for a year. Conclusion: This article emphasizes the need of diagnostic biopsy on the subungual lesions that have resistance to the conventional treatments. And if that is subungual squamous cell carcinoma, complete resection of the lesion and prophylactic inguinal lymph node dissection is essential.

• 대한골관절종양학회지
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• 제11권2호
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• pp.199-203
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• 2005

악성 흑색종은 일반적으로 피부에 발생하며 그 빈도가 매우 드문 질환이다. 특히 조갑하 흑색종은 흑색종 전체의 2% 이하로 빈도가 더욱 드물 뿐만 아니라 조갑에 발생하는 타 질환과의 감별이 어려워 초기에 오진하는 경우가 대부분이어서 예후가 나쁜 경우가 많다. 저자들은 초기에 오진된 무지 조갑하 흑색종에 대한 치료 경험을 통해 조갑하 흑색종에 대한 진단 접근법을 문헌고찰과 함께 보고하는 바이다.

• 대한골관절종양학회지
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• 제2권1호
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• pp.106-110
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• 1996

A subungual exostosis is an uncommon benign osteochondral lesion that appears as a painful nodule. Histologically, the tumors consist of a proliferating fibrocartilaginous cap that merged into mature trabecular bone at its base. From 1989 through 1991, 5 patients with subungual exostosis were treated. Three of them had exostosis on the great toe. There were three girls and two boys. The average age of the patients was 10.6 years. All of patients were treated by local excision. Two cases of our patients treated with an incomplete excision were recurred within 3 months after the original procedure. Lack of awareness of unusual lesion can cause initial misdiagnosis in many cases. We considered that a complete excision of the lesion is important for preventing the recurrence, and it should be confirmed with intraoperative radiographs.

• 대한골관절종양학회지
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• 제5권1호
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• pp.56-62
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• 1999

Purpose : This study was conducted to analyze the clinical materials and treatment results of 13 cases of subungual exostosis. Materials and Methods : Thirteen subungual exostoses of the foot treated from January 1991 to December 1997 were studied. We analyzed the clinical data and results of treatment to identify the clinical characteristics of this disease. We investigated the location, shape and relation of exostosis to phalanx with simple x-ray of the foot to identify the radiological characteristics. All the cases were sent to pathologic examination after resection to determine the pathological characteristics. Results : The results of physical examination on presentation were various. Most cases were located at the dorsomedial side of the distal phalanx and were involved in the toe nail. Eleven cases were located at great toes and one each at the 2nd and 3rd toe. Causes of exostosis were not clear, but 2 cases were related to trauma. For the type of exostosis, 7 cases were sessile and 6 were stalk type. On histologic examination, 9 cases showed a cartilaginous portion with overlying proliferating fibrous tissue and underlying bone formation. There was a gradual maturation of spindle cell proliferation from cartilage to cancellous bone. The cartilage was moderately cellular with some pleomorphism, but true anaplasia was not present. Conclusion : The clinical presentation and findings of simple x-rays were most helpful in diagnosing subungual exostosis. Complete excision of the mass achieved complete relief of symptoms and recovery without recurrence in all cases.

• 대한영상의학회지
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• 제83권5호
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• pp.1134-1140
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• 2022

혼합 종양은 상피세포와 근상피세포로 나타나는 경계가 좋은 종양이며 대게 피부와 침샘에서 발생한다. 연조직에서 발생하는 혼합 종양은 극히 드물다. 이에 따라, 연조직에서 발생한 혼합 종양에 대한 영상의학적 소견들은 영상의학 문헌에서 극히 드물게 언급되었다. 그러므로, 저자는 좌측 2번째 손가락의 통증을 주소로 내원한 65세 여자 환자의 손톱 밑 혼합 종양의 증례를 보고하고자 하며, 영상의학적 소견을 기술하고, 감별 진단들에 대해 논의하고자 한다.

• 대한족부족관절학회지
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• 제11권1호
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• pp.97-99
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• 2007

Nail bed malignancies are rare entities. Most nail bed malignancies are squamous cell carcinoma (SCC)s. Less than 10% of subungual SCCs occur in the foot. Fifty percent occurred on the hallux and approximately 25% on both the fourth and fifth digits. The correct diagnosis is often delayed because nail bed malignancies are frequently mistaken for benign or infectious processes. SCC on extremities is hard to distinguish from the benign lesion like chronic ulcer, fistula caused by chronic osteomyelitis, and abscess fistula. Attention should especially be paid in diagnosing the subungual lesion because paronychia is a common disease. SCC is the most common carcinoma second to malignant melanoma as a soft tissue malignant tumor in the West, and it involves mainly the head, neck and upper extremities but rarely involves lower extremities, particularly the toes. The authors emphasize the importance of a biopsy for chronic nonhealing lesions by presenting this case.

• Archives of Plastic Surgery
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• 제40권4호
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• pp.392-396
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• 2013

Background The typical clinical symptoms of glomus tumors are pain, tenderness, and sensitivity to temperature change, and the presence of these clinical findings is helpful in diagnosis. However, the tumors often pose diagnostic difficulty because of variations in presentation and the nonspecific symptoms of glomus tumors. To the best of our knowledge, few studies have reported on the usefulness of magnetic resonance imaging (MRI) in diagnosing glomus tumors in patients with unspecific symptoms. Methods The inclusion criteria of this study were: having undergone surgery for subungual glomus tumor of the hand, histopathologic confirmation of glomus tumor, and having undergone preoperative MRI. Twenty-one patients were enrolled. The characteristics of the tumors and the presenting symptoms including pain, tenderness, and sensitivity to temperature change were retrospectively reviewed. Results Five out of 21 patients (23%) did not show the typical glomus tumor symptom triad because they did not complain of pain provoked by coldness. Nevertheless, preoperative MRI showed well-defined small soft-tissue lesions on T1- and T2-weighted images, which are typical findings of glomus tumors. The tumors were completely resected and confirmed as glomus tumor histopathologically. Conclusions Early occult lesions of glomus tumor in the hand may not be revealed by physical examination because of their barely detectable symptoms. Moreover, subungual lesions may be particularly difficult to evaluate on physical examination. Our cases showed that MRI offers excellent diagnostic information in clinically undiagnosed or misdiagnosed patients. Preoperative MRI can accurately define the character and extent of glomus tumor, even though it is impalpable and invisible.

• Archives of Plastic Surgery
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• 제42권3호
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• pp.295-301
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• 2015

Background Glomus tumors were first described by Wood in 1812 as painful subcutaneous tubercles. It is an uncommon benign neoplasm involving the glomus body, an apparatus that involves in thermoregulation of cutaneous microvasculature. Glomus tumor constitutes 1%-5% of all hand tumors. It usually occurs at the subungual region and more commonly in aged women. Its classical clinical triad consists of pain, tenderness and temperature intolerance, especially cold sensitivity. This study reviews 15 cases of glomus tumor which were analyzed according to its anatomic location, surgical approach and histologic findings. Methods Fifteen patients with subungual glomus tumors of the hand operated on between January 2006 and March 2013, were retrospectively reviewed. Patients were evaluated preoperatively with standard physical examination including ice cube test and Love's test. Diagnostic imaging consisted of ultrasonography, computed tomography, and magnetic resonance imaging. All procedures were performed with tourniquet control under local anesthesia. Eleven patients underwent excision using the transungual approach, 3 patients using the volar approach and 1 patient using the lateral subperiosteal approach. Results Total of 15 cases were reviewed. 11 tumors were located in the nail bed, 3 in the volar pulp and 1 in the radial aspect of the finger tip. After complete excision, patients remained asymptomatic in the immediate postoperative period. In the long term follow up, patients exhibited excellent cosmetic results with no recurrence. Conclusions Accurate diagnosis should be made by physical, radiologic and pathologic examinations. Preoperative localization and complete extirpation is essential in preventing recurrence and subsequent nail deformity.