case_images: PMC5297271_01
case_images: (a) Nontender subungual, nodular lesion in the right toe; (b) after excision of the lesion
case_images: IDOJ-8-45-g001.jpg
case_images: PMC5297271_01_IDOJ-8-45-g001.jpg
case_images: F1
case_images: The physical examination showed a nontender subungual, nodular lesion with 12 mm diameter in the right big toe [Figure 1a]. The lesion was completely excised by a plastic surgeon with free margin and did not recur in 6 months follow-up [Figure 1b].
case_images: (a and b) High power view of bland spindle cells in a fibromyxoid stroma. Note the normal looking epidermis overlying the tumor (H and E x40)
case_images: IDOJ-8-45-g002.jpg
case_images: PMC5297271_01_IDOJ-8-45-g002.jpg
case_images: F2
case_images: Punch biopsy of the lesion revealed a fairly circumscribed dermal proliferation of spindled and stellate cells with loose storiform and fascicular pattern embedded in fibrocollagenous stroma with foci of myxoid change [Figure 2a and b].
case_images: Immunohistochemical (IHC) study; low power view of neoplastic spindle cells which show IHC positive staining with vimentin (a), focal reaction with smooth muscle actin (b), negative reaction with CD34 (c), and positive staining pattern with CD99 (d). (IHC x40)
case_images: IDOJ-8-45-g003.jpg
case_images: PMC5297271_01_IDOJ-8-45-g003.jpg
case_images: F3
case_images: IHC staining of our case revealed positive staining with vimentin, focal reaction with smooth muscle actin, negative reaction with CD34, and positive staining pattern with CD99 [Figure 3a+d].