Digital intraosseous epidermoid inclusion cyst of the distal phalanx

Ruchelsman, David E.; Laino, Daniel K.; Chhor, Kimberlly S.; Steiner, German C.; Kenan, Samuel

doi:10.1007/s12593-010-0001-z

Cited by 18 publications

(25 citation statements)

References 7 publications

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“…EIC is most commonly seen in the distal phalanges and this phenomenon is secondary to the unique regional anatomy as the subungual bed adheres to the underlying periosteum. 2,4 However in our case, the patient did not give any previous history of trauma.…”

Section: Dear Editormentioning

confidence: 61%

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Letter to the editor: Digital intraosseous epidermoid inclusion cyst of the distal phalanx

Saikia

Garg

Dey

2016

Diagnostic Cytopathology

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Section: Dear Editormentioning

confidence: 61%

“…1 Intraosseous epidermoid inclusion cyst is an exceedingly rare entity. 2 Herein we present a case of this rare pathological entity in the distal phalanx of the index finger.…”

Section: Dear Editormentioning

confidence: 97%

Letter to the editor: Digital intraosseous epidermoid inclusion cyst of the distal phalanx

Saikia

Garg

Dey

2016

Diagnostic Cytopathology

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“…Typically they are expansile lytic lesions with cortical thinning and little to no trabecular pattern. 7 An absence of periosteal reaction helps to differentiate from osteomyelitis.…”

Section: Discussionmentioning

confidence: 99%

Intraosseous terminal phalanx epidermoid inclusion cyst: a first case of late recurrence

Kruger

Villiers²,

McGuire

et al. 2019

SA orthop. j.

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Introduction: Epidermoid inclusion cysts (EIC) of the terminal phalanx are a rare but relevant cause of lytic lesions, particularly in the context of previous trauma to the finger. We report the first known case of late recurrence, occurring almost three decades after the incident surgery. Methods: A 56-year-old female patient presented to us with what proved to be a histologically confirmed EIC of the terminal phalanx of her ring finger, but mentioned that she was treated for the same problem some 29 years ago. Medical archive reports and the histological slide from the incident surgery confirmed an initial EIC diagnosis, for which she was treated with curettage and iliac crest autograft, recovering uneventfully. Results: Despite the 'zero' risk of recurrence, she elected to have ablative surgery through the distal interphalangeal joint and recovered well. Conclusion: Care should be taken when counselling patients about possible recurrence of an EIC of the terminal phalanx, and that this recurrence may be many years after the index procedure.

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“…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%

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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Digital intraosseous epidermoid inclusion cyst of the distal phalanx

Cited by 18 publications

References 7 publications

Letter to the editor: Digital intraosseous epidermoid inclusion cyst of the distal phalanx

Letter to the editor: Digital intraosseous epidermoid inclusion cyst of the distal phalanx

Intraosseous terminal phalanx epidermoid inclusion cyst: a first case of late recurrence

Intraosseous epidermoid cysts of adjacent digits in a dog

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