title: Pathologic fracture secondary to subungual melanoma.
abstract: Subungual melanoma is uncommon, and delays in diagnosis and misdiagnosis occur frequently. We describe a 61-year-old black male who presented with a non-healing area in his left thumb nailbed with many of the features of subungual melanoma. However, the patient also had a pathologic fracture of the distal phalanx, leading to some initial confusion about the diagnosis. Despite aggressive multimodality therapy, the disease rapidly progressed, resulting in the patient's death. Pathologic fracture due to subungual melanoma may indicate a particularly poor prognosis.
authors.affiliation: Department of Surgery, Eastern Virginia Medical School, Norfolk, VA 23507-1912, USA.
authors.forename: S
authors.initials: S
authors.lastname: Gregorcyk
authors.forename: R M
authors.initials: RM
authors.lastname: Shelton
authors.forename: L E
authors.initials: LE
authors.lastname: Ladaga
authors.forename: R R
authors.initials: RR
authors.lastname: Perry
mesh_terms: D001859:Bone Neoplasms / Q000556:secondary; D003131:Combined Modality Therapy; D017809:Fatal Outcome; D005598:Fractures, Spontaneous / Q000209:etiology*; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008545:Melanoma / Q000150:complications* / Q000556:secondary; D008875:Middle Aged; D009260:Nail Diseases / Q000150:complications*; D011379:Prognosis; D012878:Skin Neoplasms / Q000556:secondary; D013933:Thumb / Q000293:injuries*