Interactive Case Study - March 2022

Suspected Ingrown Toenail in a 17-year-old Patient

Roselyne Choiniere, MD; Philippe Echelard, MD; Dorothee Dal Soglio, MD, PhD

A 17-year-old Caucasian male presented with a solitary vegetating 1.2 cm lesion suspected of being an ingrown toenail of the left foot. Histopathologic evaluation of the lesion revealed the following features (Figures 1, 2, 3 and 4) and immunohistochemical findings (Figures 5, 6, 7 and 8).

Click this image to view the virtual slide.

Figure 1

Figure 2

Figure 3

Figure 4

Figure 5 AE1/AE3

Figure 6 CD31

Figure 7 CD34

Figure 8 INI1

Which of the following is the best diagnosis?

A.	Alveolar rhabdomyosarcoma

B.	Epithelioid angiosarcoma

C.	Epithelioid hemangioendothelioma

D.	Epithelioid sarcoma (classic)‎

E.	Pseudomyogenic hemangioendothelioma