Traumatic epidermoid cysts involving digital bones; epidermoid cysts of the distal phalanx.

Abstract

Epidermoid cysts of the digital bones can produce clinical and roentgenologic evidence of a painful, enlarging, destructive lesion and result in pathologic fractures. Unnecessary ray amputation, almost complete destruction of the distal phalanx, and severe x-ray dermatitis have been reported where the diagnosis was not established before therapy was instituted. 1 Although only 30 such cases have been reported, 2-12 there undoubtedly are many more in existence. A brief survey of the current American textbooks and journals of pathology failed to reveal any substantial discussion of this entity. In the past three and one-half years, we have had the opportunity of studying nine examples of this lesion,* and we would like to discuss the importance of the recognition of this entity. The clinical and roentgenographic features of our first four cases have been reported previously. 12 Report of Cases Case 1. —A 33-year-old white man complained of pain in his