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

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