Traumatic Epidermoid Cyst of the Terminal Phalanx

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Abstract
Traumatic epidermoid cyst of the terminal phalanx has been well documented (1, 2), but its existence is not generally realized. The unique features of this lesion are the history of trauma and fluctuation on palpation. This finding helps to differentiate it from chondroma, sarcoma, simple cyst, and giant-cell tumor. The original injury, usually to the terminal phalanx, drives sebaceous epithelium into bone, and months or years later the cyst appears and erodes or expands the phalanx. Removal of the entire cyst is curative. The accompanying figure shows a typical traumatic epidermoid cyst, subsequently removed. The patient, an eighty-three-year-old man, was a die maker by trade and received numerous finger injuries. Lesions of similar microscopy are found in the skull, brain, and spinal cord, but these are thought to result from embryonal maldevelopment.

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