An intraosseous epidermal cyst developing in a metacarpal bone after K-wire fixation: a case report

Park, Il-Jung; Kim, Hyoung-Min; Lee, Jae-Young; Park, Hyun-Woo; Kang, Soo‐Hwan

doi:10.1007/s00256-015-2186-5

Cited by 6 publications

(9 citation statements)

References 19 publications

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“…There are several reports of IECs affecting the phalanges of people with a history of previous blunt, penetrating or iatrogenic (e.g. previous surgery) trauma, supporting the traumatic theory for development of IECs [ 8 , 11 – 22 , 24 – 26 , 34 – 36 ]. The time interval from such trauma until cysts become clinically evident varies from a few weeks to years [ 8 , 11 – 22 , 24 – 26 , 35 ].…”

Section: Discussionmentioning

confidence: 92%

“…There is also a report of an IEC affecting the 10 th thoracic vertebra in a dog and the mandible in a horse [ 4 , 7 ]. In people, the phalanges of the hand and foot are a predilection site [ 8 – 22 ]; however, other reported locations include the distal radius [ 23 ], distal femur [ 24 ], proximal tibia [ 25 ], metacarpal bone [ 26 ], frontal and parietal bones of the skull [ 14 , 27 – 29 ], styloid process of the temporal bone [ 30 ] and maxilla [ 31 ]. In all previous reports in animals and humans, simultaneous involvement of multiple digits has not been reported.…”

Section: Introductionmentioning

confidence: 99%

“…In humans and animals, IECs are radiographically characterised as well-defined expansile radiolucent osseous lesions with distinct thin-walled sclerotic cortical margins [ 1 , 2 , 4 , 5 , 7 , 23 , 25 , 26 , 31 , 35 ]. Other imaging modalities that have been employed to diagnose IECs in people and less commonly in animals include computed tomography (CT) and magnetic resonance imaging (MRI) [ 2 , 11 – 14 , 16 , 18 , 19 , 23 – 25 , 27 , 29 , 30 ].…”

Section: Introductionmentioning

confidence: 99%

“…Treatment options for IECs that have been reported in dogs include digital amputation and isolated PIII amputation [ 3 – 5 , 32 ]. In the human literature, treatment options include curettage of the lesion [ 8 – 14 , 16 – 20 , 23 – 26 , 31 ], curettage combined with packing of the bone cavity with autogenous cancellous or synthetic bone graft [ 11 , 13 , 18 – 20 , 23 – 25 , 31 ], en bloc excision and amputation [ 11 , 14 , 16 , 24 , 27 ]. Regardless of the surgical technique, the mainstay of surgical treatment is to ensure complete excision of the cystic wall in order to avoid recurrence [ 19 , 23 ].…”

Section: Introductionmentioning

confidence: 99%

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Intraosseous epidermoid cysts of adjacent digits in a dog

Vagias

Cassidy²,

Skelly

et al. 2020

BMC Vet Res

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Background Intraosseous epidermoid cyst (IEC) is a rare, non-neoplastic, pathology in animals and humans that most commonly affects the distal phalanx. In dogs, it is important to differentiate this lesion from malignant digital tumours causing bone lysis. In previous reports, IEC has been described to affect only a single digit at the time of diagnosis which is usually based on histopathology. This is the first case report to describe immunohistochemically confirmed IECs affecting simultaneously multiple digits. Case presentation A 4-and-a-half-year-old female spayed Great Dane was presented with a 2-month history of progressive swelling of the distal phalanx (PIII) of digits IV and V of the right pelvic limb. Eleven weeks prior to presentation, the dog had a low-grade cutaneous mast cell tumour completely excised from the craniolateral base of its left pinna. A history of trauma to 1 of the nails of the same pes 4 years prior to referral was also reported. Examination of the right pelvic limb identified firm non-painful swelling of PIII of digits IV and V, with concurrent deformation of the nails. Radiographs of the right pes obtained by the primary veterinarian identified an expansile lesion of PIII of digits IV and V. Computed tomography identified large expansile lesions of PIII of digits IV and V, with associated cortical thinning and soft tissue swelling. Neoplasia was considered the most likely radiographic diagnosis. Histopathology of Jamshidi bone biopsies was consistent with intraosseous epidermoid cyst, which was confirmed with immunohistochemistry. Amputation of PIII of digits IV and V at the level of mid-PII was performed as definitive treatment. No recurrence of the lesion occurred during the 10-month follow-up period. Conclusions Intraosseous epidermoid cysts should be included in the differential diagnosis for expansile lesions affecting the canine digit. It is important to differentiate them from other digital lesions, with bone involvement, such as malignant digital tumours, which often require more extensive surgery for definitive treatment. The case herein highlights that this lesion can affect simultaneously multiple digits. Definitive diagnosis can be achieved by identification of keratin-producing epithelial cells on histopathology and confirmed by pancytokeratin labelling.

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Section: Discussionmentioning

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Intraosseous epidermoid cysts of adjacent digits in a dog

Vagias

Cassidy²,

Skelly

et al. 2020

BMC Vet Res

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“…Subungual intraosseous epidermoid cysts affecting the distal phalanx are rare lesions reported in humans, dogs and horses . In all species, these lesions are usually considered to be reactive or post‐traumatic pseudotumors .…”

Section: Discussionmentioning

confidence: 99%

Nail abnormalities identified in an ageing study of 30 inbred mouse strains

Mustonen

Silva

Kennedy

et al. 2018

Experimental Dermatology

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In a large-scale ageing study, 30 inbred mouse strains were systematically screened for histologic evidence of lesions in all organ systems. Ten strains were diagnosed with similar nail abnormalities. The highest frequency was noted in NON/ShiLtJ mice. Lesions identified fell into two main categories: acute to chronic penetration of the third phalangeal bone through the hyponychium with associated inflammation and bone remodelling or metaplasia of the nail matrix and nail bed associated with severe orthokeratotic hyperkeratosis replacing the nail plate. Penetration of the distal phalanx through the hyponychium appeared to be the initiating feature resulting in nail abnormalities. The accompanying acute to subacute inflammatory response was associated with osteolysis of the distal phalanx. Evaluation of young NON/ShiLtJ mice revealed that these lesions were not often found, or affected only one digit. The only other nail unit abnormality identified was sporadic subungual epidermoid inclusion cysts which closely resembled similar lesions in human patients. These abnormalities, being age-related developments, may have contributed to weight loss due to impacts upon feeding and should be a consideration for future research due to the potential to interact with other experimental factors in ageing studies using the affected strains of mice.

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