What could cause a large growth on the toe?

Question

Hello doctor,

I have a large growth on my fourth left toe and have had two opinions, NHS referral for squamous cell carcinoma and pyogenic granuloma. The photographs look like neither. But it is sore, weeping, smelly, and honestly, the word cancer has me scared to death. I did not notice it at first, but then I had blood in my sock and on the bed. Please help.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

The feature against pyogenic granuloma is the diffuse swelling of the toe, which is not common. But clinically, the pedunculated appearance and history of bleeding suggest that it can be that. Squamous cell carcinoma is usually characterized by wood-hard skin induration and is normally painless. Another possibility is poroma, a benign tumor. But it is difficult and unwise to label anything right now, and the only thing to confirm is a skin biopsy or histology, which must be done.

I hope this helps. Kindly follow up if you have more doubts.

Take care.

Answer 2

Hi,

Welcome back to icliniq.com.

I understand your concern.

Yes, I agree. The description of the fleshy and pedunculated lesion with occasional bleeding goes in favor of either eccrine poroma or pyogenic granuloma. Eccrine poroma is a benign tumor of sweat glands, and palms and soles are a very common site. Looking at the moat-like invagination surrounding the lesion, I am inclined toward that diagnosis at present. Another point in favor of eccrine poroma in your case is a hyperkeratotic rim at the base of the lesion (the white line surrounding the lesion at the base). Although it is a benign condition, in long-standing cases, secondary malignant changes can arise. I think it is eccrine poroma.

I hope this answers your query. Kindly follow up if you have more doubts.

Take care.