Subungual Metastasis from Ovarian Cancer: Case Report and Brief Review of the Literature

Abstract

Introduction: Visceral solid cancers can metastasize in almost any organ, including the skin and its appendages.

Case presentation: We report here the case of a 19-year-old Caucasian girl carrying a diagnosis of malignant germ cell tumor of the ovary, with pulmonary and brain metastases, that developed a painful red-violaceous subungual papule of the 4th finger of the left hand, associated with an over-curvature of the nail plate. Dermoscopy was characterized initially by different shades of pink and red, while after few weeks, it showed black pigmentation due to subcorneal hematomas, hemorrhagic crusts, and a rainbow pattern. Histology confirmed a diagnosis of a metastasis from a poorly differentiated carcinoma of ovarian origin.

Discussion and conclusion: A brief review on the diagnosis and treatment of subungual metastases is reported.

Keywords: Acrometastases; Metastasis; Subungual metastasis.

Fig. 1

a, b The presence of a red-violaceous subungual papule of the 4th finger of the left hand, associated with an abnormal curvature of the nail plate; dermoscopy was characterized by different shades of pink and red.

Fig. 2

a, b Papule had enlarged to become a bleeding nodule; dermoscopy showed areas of black pigmentation due to subcorneal hematomas, hemorrhagic crusts, and a rainbow pattern.

Fig. 3

a–d Histologic features were consistent with a poorly differentiated carcinoma of ovarian origin (hematoxylin and eosin, magnification ×2.5 and ×10, a, b), with positive CK7 staining (magnification ×10, c) and p63 staining (magnification ×10, d).