gms | German Medical Science

Objectives: Reporting the possibility of development in the hand of a large sized epidermal inclusion cyst, although this tumor has been reported in a small number of cases in the literature.

Method: We are reporting the case of a 68-year old patient with a large (5.5/2.5 cm) fusiform tumor, in the mediopalmar region, on the median nerve projection. The tumor had a slow growing of approximately 12 years, without any clinical symptoms, The ultrasonography revealed the presence of a polycyclic contoured, expansive, well-defined, hyperechogenic, homogeneous mass, in intimate contact with 3rd and 4th superficial flexors tendons of the fingers, suggesting a lipoma tumor. The IRM describes a polilobat cystic lesion with sizes of 21/22/53mm. Surgical treatment achieved complete ablation of a cyst with a thick, bright white capsule, and a clabber (jogurt)-like content adherent to the cyst wall. The histopathological examination established the diagnosis of epidermal inclusion cyst.

Results: The clinical and paraclinical examinations can only orient the physician to the diagnosis of epidermal inclusion cyst. The surgery has the indication of complete ablation of the cyst. The diagnosis is established by the histopathological examination. The social and professional reintegration of the patient will be complete and after a short period of convalescence.

Conclusion: In front of a tumor localized in the palm region, we have to consider the epidermal inclusion cyst among the diagnostic possibilities, even though the incidence of this tumor at this level is very low.