http://www.appliedradiology.com RSS Feed on Applied Radiologyhttp://www.appliedradiology.com//Issues/2000/01/Articles/Metastatic-pilomatrix-carcinoma-.aspxA 60-year old woman presented with a 4-week history of painful swelling of the great toe of her left foot. There was no history of trauma. Her toe was edematous, erythematous, warm, and excruciatingly tender, with no discharge or local paresthesia. A radiograph of the foot (figure 1) showed destruction of the tuft and shaft of the distal phalanx of the great toe, with associated soft-tissue swelling. During debridement and biopsy of the great toe, no exudative process was noted. This picture generated a differential diagnosis of osteomyelitis versus an aggressive bony metastatic deposit. An admission chest radiograph revealed a large pleural effusion and large pleural nodular opacities (figure 2).Wednesday, 20 Sep 2000 16:19:49 GMT