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August 2007

Nodule on the Toe—Quiz Case

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Arch Dermatol. 2007;143(8):1067-1072. doi:10.1001/archderm.143.8.1067-a

An 83-year-old woman presented with a 3-week history of an enlarging, painful lesion on her right great toe (Figure 1). The lesion's size and bleeding prevented her from wearing a shoe. She had undergone a nephrectomy 12 years earlier for renal cell carcinoma, grade 2 (of 4), with no capsular invasion, venous invasion, or nodal involvement. She also had undergone a right hemicolectomy 11 years earlier for colon cancer, with negative lymph nodes. She denied trauma, weight loss, or other constitutional symptoms. A biopsy specimen was obtained (Figure 2), and radiologic examination was performed (Figure 3).

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