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

  • Neil Kruger University of Cape Town
  • A-L de Villiers Umane Pathology Inc
  • Duncan T McGuire University of Cape Town
  • Michael Wayne Solomons University of Cape Town
Keywords intraosseous, epidermoid, inclusion cyst, enchondroma, phalanx tumour

Abstract

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.


Level of evidence: Level 5

Author Biographies

Neil Kruger, University of Cape Town

MBChB(UCT), MSc Diag Imaging (OXON), MSc (res) Orth (OXON), MMed Orth (UCT), FCS Orth (SA); Martin Singer Hand Unit, Groote Schuur Hospital, University of Cape Town, South Africa

A-L de Villiers, Umane Pathology Inc

MBChB, MMEd Anat Path; Umane Pathology Inc, Cape Town, South Africa

Duncan T McGuire, University of Cape Town

MBBCh(Wits), MMed Orth (UCT), FCS Orth (SA); Martin Singer Hand Unit, Groote Schuur Hospital, University of Cape Town, South Africa

Michael Wayne Solomons, University of Cape Town

MBChB(UCT), FCS Orth (SA); Professor and HOD, Martin Singer Hand Unit, Groote Schuur Hospital, University of Cape Town, South Africa

Published
2019-04-17
How to Cite
KRUGER, Neil et al. Intraosseous terminal phalanx epidermoid inclusion cyst: a first case of late recurrence. South African Orthopaedic Journal, [S.l.], p. 49-52, apr. 2019. ISSN 2309-8309. Available at: <http://journal.saoa.org.za/index.php/saoj/article/view/287>. Date accessed: 23 aug. 2019.
Section
Hand Surgery

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