PMC7104197_01
Subungual painful mass in the left thumb at presentation.
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F0001
Oncology department because of a painful subungual mass in the left thumb, which has been growing rapidly over the prior 4 months. On physical exam, an inflammatory mass with hemorrhagic suffusion and nail extrusion was observed (Figure 1).
PMC7104197_02
PMC7104197_03
Macroscopic appearance the subungual mass: infiltrative soft tumor, paler than normal tissue.
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F0002
Given her history and the macroscopic appearance the subungual mass (Figure 2), a biopsy was taken after nail resection.
Hematoxilyn-eosin (H-E) comparison of primary HCC (A) and nail-bed metastasis (B). In both micrographs can be appreciated that tumor cells grow in cords and nests of variable thickness that are separated by sinusoid-like blood spaces (trabecular and compact architectural pattern) giving the tumor a solid appearance. (10X).
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F0003
The thumb was amputated, and path exam confirmed the diagnosis of HCC metastasis in the nail-bed (Figures 3-5) with intact phalanx bone.
CK7 staining comparison of primary HCC (A) and nail-bed metastasis (B), both negative (10X).
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F0004
The thumb was amputated, and path exam confirmed the diagnosis of HCC metastasis in the nail-bed (Figures 3-5) with intact phalanx bone.
Another immunohistochemistry (IHC) features of the nail-bed HCC metastasis: AFP positive (A), glypican 3 positive (B) and Ki67 (C) (10X).
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F0005
The thumb was amputated, and path exam confirmed the diagnosis of HCC metastasis in the nail-bed (Figures 3-5) with intact phalanx bone.