A case report of onycholemmal carcinoma in a 61-year-old Chinese male

Abstract

Onycholemmal carcinoma is characterized as a slowly progressing malignant tumor originating from the epithelium of the nail bed. A limited number of cases have been documented in the English literature. The majority of the patients included in the reports underwent amputation of the affected phalanx, and no instances of recurrence were noted during the follow-up period. A 61-year-old Chinese male presented with a persistent ulceration on the nail bed of the right great toe. Microscopic analysis indicated the presence of an epithelial tumor consisting of small keratocysts with sudden central keratinization and atypical keratinocyte nests that were devoid of a granular layer. The tumor exhibited infiltrative growth within the dermis, displaying a multilobulated pattern, but did not extend into the distal phalangeal bone. Based on these findings, the diagnosis of onycholemmal carcinoma was made for this case. All documented cases indicate that onycholemmal carcinoma is a rare malignant tumor originating from the nail bed epithelium, and its clinical progression is typically slow and non-aggressive. This case is presented to provide an analysis of the clinical and pathological features of onycholemmal carcinoma, aiming to assist in the clinical selection of treatment options.