Submural tumours and masses of the foot

Solar keratoma: An atypical case

“…Most authors consider keratomas to be slow-growing, benign, hyperplastic masses that occupy space in the affected anatomic area (Hamir, Kunz & Evans 1992 ; Honnas, Dabareiner & McCauley 2003 ; O’Grady & Horne 2001 ) and are associated with variable clinical signs (Redding & O’Grady 2012 ). Although uncommon as a cause of lameness, keratomas are clinically well documented (Floyd & Mansmann 2007 ; Hamir et al 1992 ; Lloyd et al 1988 ; Moyer 2008 ). The most common presenting complaint is recurrent lameness and abscessation of the hoof (Pickersgill 2000 ).…”

“… 1992 ; Lloyd et al 1988 ; Moyer 2008 ; Pickersgill 2000 ), as radiography may be inconclusive because of the soft tissue detail limitations (Boys Smith et al 2006 ; Honnas 1997 ; Schulze et al 2006 ), the location of the keratoma or the extent of growth (Chan & Munroe 1997 ). Differential diagnoses include squamous cell carcinoma, malignant melanoma, mast cell tumour, glomus tumour and fibroma (Brounts et al 2008 ; Durham & Walmsley 1997 ; Moyer 2008 ; Valentine et al 2000 ), as well as septic and nonseptic pedal osteitis (Cauvin & Munroe 1998 ; Chaffin et al 1989 ; Chan & Munroe 1997 ). Recently, however, magnetic resonance imaging (MRI) has allowed for easier diagnosis of keratomas of atypical appearance (Mair & Linnenkohl 2012 ).…”

“…Surgical excision of all abnormal tissue is currently the preferred treatment (Honnas 1997 ; Honnas et al 2003 ; Pickersgill 2000 ; Redding & O’Grady 2012 ), either by dissection or by curettage (Moyer 2008 ), followed by therapeutic shoeing (Ange 2010 ). Prognosis after uncomplicated complete surgical excision is good (Boys Smith et al 2006 ; Dyson 2003 ; Floyd & Mansmann 2007 ; McDiarmid 2007 ; Wagner et al 1986 ) and is associated with significantly better outcome than conservative treatment (83% vs 43% success rate) (Furst & Lischer 2006 ).…”