case_images: PMC7104197_01
case_images: Subungual painful mass in the left thumb at presentation.
case_images: JHC-7-39-g0001.jpg
case_images: PMC7104197_01_JHC-7-39-g0001.jpg
case_images: F0001
case_images: 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).
case_images: PMC7104197_02
case_images: PMC7104197_03
case_images: Macroscopic appearance the subungual mass: infiltrative soft tumor, paler than normal tissue.
case_images: JHC-7-39-g0002.jpg
case_images: PMC7104197_03_JHC-7-39-g0002.jpg
case_images: F0002
case_images: Given her history and the macroscopic appearance the subungual mass (Figure 2), a biopsy was taken after nail resection.
case_images: 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).
case_images: JHC-7-39-g0003.jpg
case_images: PMC7104197_03_JHC-7-39-g0003.jpg
case_images: F0003
case_images: The thumb was amputated, and path exam confirmed the diagnosis of HCC metastasis in the nail-bed (Figures 3-5) with intact phalanx bone.
case_images: CK7 staining comparison of primary HCC (A) and nail-bed metastasis (B), both negative (10X).
case_images: JHC-7-39-g0004.jpg
case_images: PMC7104197_03_JHC-7-39-g0004.jpg
case_images: F0004
case_images: The thumb was amputated, and path exam confirmed the diagnosis of HCC metastasis in the nail-bed (Figures 3-5) with intact phalanx bone.
case_images: Another immunohistochemistry (IHC) features of the nail-bed HCC metastasis: AFP positive (A), glypican 3 positive (B) and Ki67 (C) (10X).
case_images: JHC-7-39-g0005.jpg
case_images: PMC7104197_03_JHC-7-39-g0005.jpg
case_images: F0005
case_images: The thumb was amputated, and path exam confirmed the diagnosis of HCC metastasis in the nail-bed (Figures 3-5) with intact phalanx bone.