Subungual verrucous carcinoma of the thumb treated by intra-arterial infusion with methotrexate.
BACKGROUND
For preservation of integrity of appearance and function in a 66-year-old male with an extremely rare case of verrucous carcinoma developing from the subungium of his right thumb, intra-arterial infusion with methotrexate was used.


OBJECTIVE
To evaluate the effectiveness of arterial infusion with methotrexate in this unusual nail bed cancer.


METHODS
Right brachial arterial catheterization and infusion with methotrexate (50 mg) were used every 24 hours together with simultaneous intramuscular injection of 6 mg of leucovorin every 6 hours for 10 days.


RESULTS
At 4 years, 8 months after therapy, the patient was in sustained complete remission with a functionally normal right thumb.


CONCLUSIONS
This case study suggests that intra-arterial infusion chemotherapy is a simple and effective method for thumb subungual verrucous carcinoma with the unique advantage of preservation of morphology and functional conditions. It can be considered an effective treatment option.
Sheen
Maw-Chang
MC
Department of Surgery, Division of Surgical Oncology, Kaoshing Medical University Hospital, Taiwan.
Sheen
Yi-Shuan
YS
Sheu
Hamm-Ming
HM
Wong
Tak-Wah
TW
Lee
Yu-Yun
YY
Wu
Chih-Fung
CF
Wang
Yi-Wen
YW
Chai
Chee-Yin
CY
D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D018289:Carcinoma, Verrucous / Q000188:drug therapy*; D006801:Humans; D007261:Infusions, Intra-Arterial; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage*; D009260:Nail Diseases / Q000188:drug therapy*; D012878:Skin Neoplasms / Q000188:drug therapy*; D013933:Thumb; D016896:Treatment Outcome
D000970:Antineoplastic Agents; D008727:Methotrexate