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

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.

Squamous Cell Carcinoma Arising from Chronic Osteomyelitis in the Extremities: Treatment Approach and Oncological Outcomes—A Systematic Review of the Literature

“…The following articles were analyzed in this section [ 13 , 15 – 25 , 27 , 29 – 34 , 37 , 38 ] as they reported risk factors associated with worse outcomes. Although not statistically significant ( p =0.579), trauma-originated COM-derived SCC was associated with a lower metastasis rate (2/22, 9.09%) compared with other etiologies (1/7, 14.29%) ( Table 3 ).…”

“…COM-related SCC has been intermittently reported in case reports, case series, or small retrospective studies that often fail to establish a true causal relationship between COM and SCC [ 13 , 15 – 38 ]. Additionally, available literature reviews [ 39 ] on the subject incorporate patient populations that mix specific data from COM-derived SCC with the broader condition of Marjolin ulcer, as well as COM that developed as a complication of a pre-existing SCC.…”

Large Lobular Capillary Hemangioma Associated with Ingrown Toenail: Histopathological Features and Case Report

“…The role of trauma in the induction of nail tumors is well known, and pathology is mandatory in these cases to exclude a PG [ 3 ]. Although GT and PG are frequent benign lesions in the nail unit, the presence of GT or PG may clinically masquerade malignant tumors, such as amelanotic melanoma, squamous or basal cell carcinoma, and Kaposi’s sarcoma [ 4 , 5 , 6 , 7 ].…”