Intraosseous epidermal inclusion cyst of the right ring finger for 40 years

Meng-Qiang Fan; Xiao-Lei Chen; Jiang Hua; Lei-Pei Wang; Yong Huang; Jie-Feng Huang

doi:10.2298/VSP200817100F

Meng-Qiang Fan The First Affiliated Hospital of Zhejiang Chinese Medical University, Department of Orthopaedics, Hangzhou, China
Xiao-Lei Chen Shanghai University of Traditional Chinese Medicine, Basic Medical College, Shanghai, China
Jiang Hua The First Affiliated Hospital of Zhejiang Chinese Medical University, Department of Orthopaedics, Hangzhou, China; Zhejiang Chinese Medical University, The First Clinical College, Hangzhou, China
Lei-Pei Wang Zhejiang Chinese Medical University, Basic Medical College, Hangzhou, China
Yong Huang Hospital of Chengdu University of Traditional Chinese Medicine, Department of Orthopaedics, Chengdu, China
Jie-Feng Huang The First Affiliated Hospital of Zhejiang Chinese Medical University, Department of Orthopaedics, Hangzhou, China; The First Clinical College, Hangzhou, China

DOI: https://doi.org/10.2298/VSP200817100F

Keywords: amputation;, bone cysts;, crush injuries;, epidermal cyst;, fingers;, hand.

Abstract

Introduction. Intraosseous epidermal inclusion cysts (IEpC) are benign bone lesions lined with squamous epithelium. Finger phalanges are the second most common site of predilection after the skull. Case report. We presented a case of a typical IEpC at the distal phalanx of the right ring finger following a remote history of a crush injury to the finger (40 years earlier). The patient experienced painful enlargement and progressive swelling of that finger during the previous month. On physical examination, the finger showed typical “clubbing” with local tenderness. X-ray showed bone destruction, and magnetic resonance imaging (MRI) revealed abnormal signals in bone tissue in the distal phalanx of the right ring finger. The patient underwent distal phalanx amputation of the right ring finger. The diagnosis of IEpC was histopathologically confirmed. At follow-up 2 years later, the stump healed well and without recurrence. Conclusion. IEpC with a history of up to 40 years is very rare, and although the patient presents with a typical “clubbing” finger, the diagnosis was eventually confirmed by surgery and pathology.

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