PMC3930812_01
Images of cervical cancer toe metastasis in Case 1.. A) Dorsum of left fourth toe, notable for profuse swelling, erythema, and necrosis of the distal phalanx. B) Lateral view of the same toe. C) Plain film of the left foot, showing soft tissue swelling with erosion and resorption of the fourth distal phalanx. D) Hematoxylin and eosin staining of the toe following amputation, showing nests of metastatic squamous carcinoma, with necrosis, in a fibrous stroma, infiltrating the marrow space of the distal phalanx.
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On physical examination, the distal portion of her left fourth toe was erythematous, enlarged, and tender to palpation, without proximal extension (Fig. 1A-B). Radiographic evaluation of the foot revealed erosion and resorption in the fourth distal phalanx with extensive soft tissue edema (Fig. 1C). She underwent an uncomplicated toe amputation, and histological evaluation revealed metastatic squamous cell carcinoma to the distal phalanx (Fig. 1D).
PMC3930812_02
Images of cervical cancer toe metastasis in Case 2.. A) Dorsum of the left first toe, showing diffuse erythema, scaling, and necrosis. B) Lateral view of the same toe. C) X-ray of the left foot, showing diffuse sclerosis of the first distal phalanx with soft tissue swelling. D) Hematoxylin and eosin staining of the toe following amputation, showing nests of tumor cells occupying the marrow space of the distal phalanx and invading into the bone trabeculae.
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On physical examination, her left hallux was erythematous, enlarged, and necrotic-appearing, with areas of purple and black discoloration around the nail (Fig. 2A-B). Radiographic imaging showed increased soft tissue density and swelling with sclerosis around the distal phalanx (Fig. 2C). She underwent palliative amputation of the left first toe, and histology confirmed metastatic cervical cancer with invasion into the bone, soft tissue, and dermis (Fig. 2D).