RENAL-CELL CARCINOMA METASTATIC TO THE THUMB - A CASE-REPORT AND REVIEW OF SUBUNGUAL METASTASES FROM ALL PRIMARY SITES

Subungual metastatic cancer from any primary site is rare. Only seven cases from primary renal cell carcinoma have previously been reported. We now describe a further example of this condition and review its cl inical features, radiographic findings and pathological changes. The d iagnosis of subungual metastasis should be considered in any patient w ith metastatic cancer who develops a new lesion of the distal phalanx. Subungual metastatic cancer in general is uncommon, and metastasis fr om a primary renal cell carcinoma to beneath the nail plate is also ve ry rare, only seven cases having previously been described. Typically, such lesions present with swelling, erythema and tenderness mimicking an infectious process such as a felon, whitlow or paronychia.(1-4) We now present a further patient with the condition, who developed a sub ungual nodular metastasis of the left thumb. The clinical features, ra diographic findings and pathological changes in our patient and the pr eviously reported cases are discussed in detail (Table 1),(5-11) and s ubungual metastases in general are also briefly discussed.