Most people think of an ingrown toenail as a painful nuisance handled with warm soaks or a quick visit to a foot specialist. For one 44-year-old man in South Korea, it ended with an irregular mass on his right big toe measuring about 7 by 4 by 8.5 centimeters, roughly 3.3 inches at its longest and bigger than a golf ball.
Orthopedic surgeons affiliated with Jeonbuk National University Hospital removed the growth and sent it for testing. It was not cancer. Their case report in the journal Medicine, published in January 2024, identified it as a hypertrophic scar, an overgrowth of scar tissue, driven by years of irritation around a chronic ingrown nail.
The size alone is striking. What makes the case unusual is that a scar grew large and strange enough to look like a tumor.
Three Years, One Stubborn Wound
According to the report, the man had an ingrown nail removed from his right big toe three years earlier. Afterward, he cared for the wound himself, and it was exposed to repeated minor trauma. Over time, it grew into a tumor-like mass that caused him intolerable discomfort.
When he arrived at the clinic, the growth had an irregular, bizarre shape with a 2-by-2-centimeter ulcer at its tip. It appeared to grow from a stalk on the outer side of the nail bed.
His left big toe showed an earlier chapter of the same story. It had an inflamed ingrown nail with redness and tenderness along both sides, but no giant mass. The authors described the pair as bilateral ingrown nails at different phases, offering a side-by-side look at how the problem can progress.
A Scar That Mimicked a Tumor
The surgeons performed excisional biopsies on both big toes. The analysis confirmed chronic ulcerative inflammation with a hypertrophic scar.
Hypertrophic scars are raised scars that form when normal wound healing goes awry. They are usually distinguished from keloids, which spread well beyond the original wound, so a hypertrophic scar of this size is unusual. According to the PubMed abstract, the authors concluded that the natural course of an untreated ingrown nail may produce a hypertrophic scar that extends far enough to mimic a tumor. They attributed the growth to ongoing stimulation from the chronic ingrown nail.
The surgical site healed and remained in good condition at the 12-month follow-up.
The case is not entirely without precedent. A 2017 report in SAGE Open Medical Case Reports described a 31-year-old man with extensive hypertrophic scarring on both big toes after a decade of untreated ingrown nails, which was managed surgically. That report also called the condition rare.
Why a Biopsy Mattered
A toe mass that grows for years and ulcerates cannot safely be labeled harmless by appearance alone. That is why tissue testing mattered here. Only examination under a microscope can confirm whether a growth is a scar, an inflammatory overgrowth or a cancer.
Cancers near the nail can masquerade as common problems. A 2023 report in the Journal of the American Podiatric Medical Association described a 59-year-old man with a rapidly growing mass on his big toe three months after treatment for an ingrown toenail and infection. It turned out to be a rare form of melanoma. The two cases are very different, but together they show why an unusual growth near the nail deserves a professional evaluation rather than more home care.
The Korean authors reached a broader conclusion from their patients' two feet. Poorly controlled ingrown nails, they wrote, can lead to scarring that grows far enough to resemble a tumor, creating physical and social problems as well as cosmetic ones.
When a Sore Toe Needs Professional Care
Ingrown toenails are common and usually manageable. According to MedlinePlus, from the National Library of Medicine, they most often affect the big toe, and poorly fitting shoes and improperly trimmed nails are the most common causes. Most never come close to what happened in this case, which the authors describe as rare. For most people, the realistic risks of an untreated ingrown nail are persistent pain and infection, which in severe cases can spread into the bone.
MedlinePlus advises people with diabetes, nerve problems in the legs or feet, poor circulation to the feet, or an infection around the nail to contact a health care provider right away rather than treating an ingrown nail at home. It also recommends calling a provider for severe pain, redness, swelling or fever, or when home care is not working.
Prevention is simple. The agency recommends shoes with plenty of room around the toes and trimming toenails straight across, without rounding the corners or cutting them too short. It also warns against picking or tearing at the nails and against trying to cut out the ingrown portion yourself, which only makes the problem worse.
A toe wound that keeps growing, bleeding, ulcerating, or changing shape after nail surgery also warrants a return visit. As this case shows, even a benign process can become disabling when it is left to build for years.
Key Questions Answered
What happened to the man's toe?
After an ingrown toenail was removed, his self-managed wound was repeatedly irritated for three years and grew into a mass measuring about 7 by 4 by 8.5 centimeters on his right big toe.
Was the growth cancer?
No. A biopsy showed chronic ulcerative inflammation with a hypertrophic scar, a benign overgrowth of scar tissue.
Why was this case unusual?
The scar grew so large and irregular that it resembled a tumor. The authors describe this outcome of a chronic ingrown nail as rare.
How was it treated?
Surgeons removed the mass. The site healed and remained in good condition at the 12-month follow-up.
Are giant growths from ingrown toenails common?
No. Most ingrown toenails are managed with home care or a simple procedure. Persistent pain and infection are the more typical risks.
When should someone see a doctor for an ingrown toenail?
Right away if they have diabetes, nerve problems in the legs or feet, poor circulation, or an infection around the nail. They should also seek care for severe pain, redness, swelling, or fever; when home care is not working; or for a wound that keeps growing or changing.
Published by Medicaldaily.com
