Ultrasound features of the subungual glomus tumor and squamous cell carcinomas

Skin Res Technol. 2020 Nov;26(6):867-875. doi: 10.1111/srt.12888. Epub 2020 Jun 25.

Abstract

Background: Nail tumors often pose a significant challenge for the clinician, as they are burdened by a high delay in diagnosis and paucity of clinical signs in the early stage. In most cases, the onset of pain or nail plate dystrophy leads to imaging investigations such as plain radiography, magnetic resonance imaging, and ultrasonography (US) when surgery is pending.

Material and methods: A 2-year monocentric study evaluated the histologically confirmed cases of subungual glomus tumor (GT) and squamous cell carcinoma (SCC) with a pre-surgical US assessment, and reviewed their sonography features. A total of 7 digital GTs and 6 SCCs of the nail were collected.

Results: GT and SCC are easily distinguishable on US. Compared to SCC, GT was positively associated with an ovoid shape, well-defined borders, bone cup-scalloping without cortical erosion, and a rich intralesional vascular pattern (P < 0.05). Vice versa, SCC was significantly correlated with irregular shape, ill-circumscribed margins, an infiltrative growth pattern with peripheral hypoechoic foci, posterior acoustic shadow, cortical erosion, and a highly vascular multipolar peripheral pattern (P < 0.05).

Conclusion: The rapid assessment of GT and SCC sonographic features may contribute to reduce diagnostic delay, expedite management, and decrease the risk of surgical relapse.

Keywords: glomus tumor; nail; nail tumor; squamous cell carcinoma; ultrasonography; ultrasound.

MeSH terms

  • Carcinoma, Squamous Cell* / diagnostic imaging
  • Carcinoma, Squamous Cell* / surgery
  • Delayed Diagnosis
  • Glomus Tumor* / diagnostic imaging
  • Glomus Tumor* / surgery
  • Humans
  • Nail Diseases* / diagnostic imaging
  • Nail Diseases* / surgery
  • Neoplasm Recurrence, Local
  • Skin Neoplasms* / diagnostic imaging
  • Ultrasonography