Intraosseous epidermoid cyst of the third phalanx in a thoroughbred gelding

Fraser, B. S. L.; Else, R W; Jones, Ellis L.

doi:10.1136/vr.159.11.360

Cited by 15 publications

(27 citation statements)

References 9 publications

(4 reference statements)

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“…In addition to the distal phalanx, epidermoid cysts have been noted in the mandible and deep digital flexor tendon of horses (Camus et al . 1996; Fraser et al . 2006; Sanz et al .…”

Section: Intraosseous Epidermoid Cystsmentioning

confidence: 99%

“…There are 2 case reports of horses diagnosed with intraosseous epidermoid cysts (also known as epidermal inclusion cysts, follicular cysts or infundibular cysts) in the distal phalanx (Fraser et al 2006;Headley et al 2009). In addition to the distal phalanx, epidermoid cysts have been noted in the mandible and deep digital flexor tendon of horses (Camus et al 1996;Fraser et al 2006;Sanz et al 2006;Headley et al 2009). Intraosseous epidermoid inclusion cysts are rare pseudoneoplastic lesions caused by proliferation of epidermoid cells within a bone (Patel et al 2006).…”

Section: Intraosseous Epidermoid Cystsmentioning

confidence: 99%

“…Of the 2 cases reported in the distal phalanx of horses, one was in the left forelimb of a gelding at the lateral toe (Fraser et al 2006) and 2 were present in the left hindlimb in a mare; one was close to the toe of the distal phalanx and one was at the plantar lateral side of the wing of the distal phalanx (Headley et al 2009). Neither horse had lesions near or communicating with the articular surface of the DIP joint in contrast to the commonly identified locations of OCLLs.…”

Section: B) Bone Phase (2 H) Nuclear Scintigraphic Dorsopalmar Image mentioning

confidence: 99%

“…Both horses demonstrated an inconsistent but progressive lameness (Fraser et al 2006;Headley et al 2009) localised to the hoof through a combination of physical examinations, hoof tester application and perineural analgesia of the digital nerves at the level of the proximal sesamoid bones. Radiographically, these lesions appear as a radiolucency within the bone which can sometimes be surrounded by a sclerotic rim; however, there may be irregular areas of radiodensity within the lesions.…”

Section: B) Bone Phase (2 H) Nuclear Scintigraphic Dorsopalmar Image mentioning

confidence: 99%

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Osseous cyst-like lesions/subchondral bone cysts of the phalanges

Sherlock¹,

Mair

2011

Equine Veterinary Education

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Summary In the horse, the phalanges are the second most common location for the occurrence of osseous cyst‐like lesions (OCLLs) after the medial femoral condyle of the stifle. Phalangeal OCLLs occur in a variety of locations, most of which are adjacent to, if not communicating with, a joint. The aetiology of these lesions is considered to be multifactorial by most authors. Horses with OCLLs demonstrate lameness of varying severity. Diagnostic analgesia should be used to localise the lameness. After localisation of the lameness, standard radiographic views of the isolated area should be performed. The radiographic characteristics of OCLLs are dependent on the stage of development of the OCLL; OCLLs may first be identified as a small lucent flattening or depression in the articular surface; however, they may progress to a circular, oval or conical single or multi chambered radiolucency within the bone. There may be a rim of radiodense sclerosis around the lucency. Diagnosis of some OCLLs may only be achieved using nonstandard radiographic views or may require advanced diagnostic imaging modalities such as computed tomography or magnetic resonance imaging. Treatment of phalangeal cysts may be conservative or surgical. Surgical treatment options generally aim to prevent cyst enlargement and promote filling of the lesion with osseous material. Depending on the cyst, this can be performed arthroscopically or via an extra‐articular approach. Occasionally, the severity of proximal interphalangeal joint OCLLs warrants surgical arthrodesis. Overall the prognosis for return to performance for horses with OCLLs ranges from 30–90% but is dependent on the breed, age and intended use of the horse, surface area of weightbearing cartilage affected, concurrent osteoarthritis within the joint and treatment administered.

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“…In addition to the distal phalanx, epidermoid cysts have been noted in the mandible and deep digital flexor tendon of horses (Camus et al . 1996; Fraser et al . 2006; Sanz et al .…”

Section: Intraosseous Epidermoid Cystsmentioning

confidence: 99%

Section: Intraosseous Epidermoid Cystsmentioning

confidence: 99%

Section: B) Bone Phase (2 H) Nuclear Scintigraphic Dorsopalmar Image mentioning

confidence: 99%

Section: B) Bone Phase (2 H) Nuclear Scintigraphic Dorsopalmar Image mentioning

confidence: 99%

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Osseous cyst-like lesions/subchondral bone cysts of the phalanges

Sherlock¹,

Mair

2011

Equine Veterinary Education

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“…Infectious osteomyelitis of the distal phalanx was considered unlikely as this would appear as a more irregularly margined radiolucent lesion. Secondly, epidermoid cysts are reported to be surrounded by a sclerotic rim (Fraser et al . 2006; Headley et al .…”

Section: Discussionmentioning

confidence: 99%

Severe lameness caused by metastatic renal adenocarcinoma of the third phalanx in a Warmblood mare

Oosterlinck¹,

Raes²,

Verbraecken³

et al. 2011

Equine Veterinary Education

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Summary Malignant osseous neoplasia has been extremely rarely reported in the horse and, therefore, it is not commonly considered as a differential diagnosis for acute lameness. In the present report, a 19‐year‐old Warmblood mare in poor body condition and with a history of chronic haematuria, presumably attributable to renal neoplasia, was referred with acute, progressive, unilateral right forelimb lameness with marked unilateral digital pulsation and metacarpal oedema. No hoof abscess was found. Radiographic examination revealed a well defined osteolytic area in the dorsomedial half of the third phalanx. Dermal laminae at the dorsomedial aspect of the hoof showed a dark red appearance with poor vascularisation. Thoracic radiographs revealed pulmonary nodules. As osseous metastasis of the third phalanx was suspected, the mare was subjected to euthanasia. Post mortem histopathological examination confirmed the diagnosis of primary renal adenocarcinoma with metastasis to the lungs, myocardium, along the perirenal lymphatic tract and to the third phalanx, with extensive osteolysis in the latter location. Post mortem computed tomography of the hoof provided excellent visualisation of the osseous metastasis. The rare possibility of osseous metastatic neoplasia should be included in the differential diagnosis of severe lameness, especially in aged horses with a history of chronic renal disease.

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