Metastatic Endometrioid Carcinoma Mimicking a Subungual Melanoma.

CASE: We report a case of a 76-year-old female with a stage IB, grade I endometrioid endometrial carcinoma who presented with right-hip pain and an enlarging black, exophytic, subungual lesion on her right-small-finger distal phalanx. Clinically, the distal phalanx lesion was suspicious for a subungual melanoma; however, advanced imaging suggested metastatic disease, with lesions in the acetabulum, lungs, brain, vulva, and vagina. CONCLUSION: Partial amputation of the right, small finger and vulvar biopsies confirmed an endometrial carcinoma. To our knowledge, this is the first described case of endometrial adenocarcinoma metastasis to the phalanx of an upper extremity, mimicking a subungual melanoma.

Percent of Normal: A Pragmatic Patient-Reported Outcome Measure for the Orthopaedic Trauma Clinic.

OBJECTIVES: To compare a single numerical patient-reported outcome measure (PROM) to general health and injury-specific PROMs. DESIGN: Retrospective cohort. SETTING: Urban Level 1 trauma center. PATIENTS/PARTICIPANTS: The study included 175 patients with 34 humerus, 54 pelvis, 31 acetabular, and 56 ankle fractures. MAIN OUTCOME MEASUREMENTS: Patients were administered 3 PROMs: the 12-item short-form (SF-12), an injury-specific PROM (QuickDASH-humerus; Majeed Pelvic Outcome Score (Majeed)-pelvis; modified Merle d'Aubigne score (Merle)-acetabular; Foot and Ankle Disability Index (FADI)-ankle, and the Percent of Normal (PON) PROM, a single numerical PROM, which asked, "How would you rate yourself, if 100% is back to normal?" Floor/ceiling effect, convergent validity, and responsiveness of PROMs were assessed. RESULTS: None of the PROMs demonstrated a floor effect. The Merle was the only PROM with a ceiling effect (19%). The PON had a strong correlation with the QuickDASH (r = 0.78) and Majeed (r = 0.78); a moderate association with the SF-12 physical component score (r = 0.63), Merle (r = 0.67), and FADI (r = 0.55); and a weak association with the SF-12 mental component score (r = 0.22). The regression coefficient for change in PROM over time, a measure of responsiveness, was greater for the PON compared with the SF-12 physical component score/mental component score, Majeed, Merle, and FADI, but not the QuickDASH. CONCLUSIONS: The PON is a pragmatic PROM that can be easily administered in clinic by the physician to quickly assess and manage a variety of fractures, avoiding the disadvantages of nonrelative general or region-specific PROMs.