Marjolin's squamous cell carcinoma of the hallux following recurrent ingrown toenail infections

BMJ Case Rep. 2017 Jun 14:2017:bcr2017219715. doi: 10.1136/bcr-2017-219715.

Abstract

Marjolin's squamous cell carcinoma (SCC) affecting the toe is rare. Due to resemblance with benign conditions it can often result in misdiagnosis. We report a case of Marjolin's SCC affecting the proximal hallux in a patient with recurrent ingrown toenail infections. A 58-year-old woman with a background of wedge resections for ingrown toenail and distal phalanx amputation for osteomyelitis presented with pain and hyperkeratotic raised ulcer around the proximal phalanx. MRI scan revealed soft tissue mass infiltrating the proximal phalanx with biopsies confirming a SCC. The patient underwent first ray amputation and made a good clinical recovery and remains disease free. Due to clinical similarities with benign conditions, awareness of Marjolin's SCC as a potential diagnosis when treating patients with recurrent ingrown toenail is imperative. We recommend patients with recurrent ingrown toenail or ulceration with a background of chronic infection have biopsies performed to exclude potential malignancy.

Keywords: Orthopaedic And Trauma Surgery; Skin Cancer.

Publication types

  • Case Reports

MeSH terms

  • Amputation, Surgical
  • Carcinoma, Squamous Cell / diagnosis*
  • Carcinoma, Squamous Cell / diagnostic imaging
  • Carcinoma, Squamous Cell / pathology
  • Carcinoma, Squamous Cell / surgery
  • Female
  • Hallux*
  • Humans
  • Magnetic Resonance Imaging
  • Middle Aged
  • Nails, Ingrown*
  • Skin Neoplasms / diagnosis*
  • Skin Neoplasms / diagnostic imaging
  • Skin Neoplasms / pathology
  • Skin Neoplasms / surgery
  • Tinea Pedis*