Epidermal inclusion cyst of phalanx: a case report and review of the literature

Abstract

Epidermal cyst within a toe phalanx is an extremely rare condition. It is important to differentiate this benign lesion, which can be easily treated by curettage, from other benign and malignant lesions of the bone with a similar clinical presentation, and which may require amputation of the toe. This report describes one such lesion in the mid-phalanx of the fourth toe in a 48-year-old woman, and which was successfully identified by intra-operative frozen diagnosis and treated by curettage.

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

“…They are most common in individuals aged 25-50 years and males are three times more likely to be affected than females [12]. IEC is generally slow growing, accompanied either by a lump or swelling, or pain and/or tenderness at the affected site [6,16]. The pathogenesis remains unclear, but damage to the bone caused by trauma with subsequent infiltration of epidermal cells is the probable explanation [1,13].…”

“…Patel et al [6] reported an IEC that developed in the fourth toe after hammertoe correction, and Kurosawa et al [7] reported a recurrent postoperative IEC of the distal phalanx. Our case presented with a postsurgical IEC, as in the cited studies, but K-wire fixation has not previously been linked to IEC development; thus, we report the present new iatrogenic complication of K-wire fixation [17].…”

“…Although epidermal cysts have developed after both trauma and dermal grafts [2,4,5], to the best of our knowledge, a few case reports have described postoperative IECs [6,7]. Here, we report the case of a patient who fractured her fifth metacarpal and developed an IEC in the track used for the trans-metacarpal K-wire fixation of the fracture.…”

Subungual Tumors: Clinicopathologic Correlation with US and MR Imaging Findings

“…Most theories proposed to explain the presence of intraosseous epidermal cysts are similar to those put forth to explain the presence of other types of epidermal cysts. However, one theory is that intraosseous epidermal cysts are the result of epidermal cysts from subungual soft tissue eroding into underlying bone (31). Thus, it is not certain whether softtissue and intraosseous epidermal cysts are two discrete disease entities.…”

Tumours and Tumour-Like Lesions of Bone

“…On radiographs, they usually appear as a well-defined, unilocular, osteolytic lesion with a sclerotic margin (Fig. 23) and may exhibit spotty calcifications (Musharrafieh et al 2002;Patel et al 2006). Enchondroma is the major differential diagnosis, but unlike intraosseous epidermal cysts, it is rarely symptomatic in the absence of a fracture.…”