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

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 con-firmed by surgery and pathology.

Keywords

• amputation
• bone cysts
• crush injuries
• epidermal cyst
• fingers
• hand