Epidemiology
Most frequent tumour around distal phalanx
M>F 2:1
Mean age 3rd decade
Aetiology
Likely traumatic
- subcutaneous implantation of keratinising epithelium that continues to grow and produce keratin
Clinical
Painless firm swellings
Most common volar aspect P3 index / middle
X-ray
Round / oval lesion in P3
- thinning of cortex
Pathology
Fibrous capsule with keratin filled space
Squamous epithelium
DDx
Foreign Body Granuloma
Management
Curettage and bone grafting (if bony)
Excision of lump
- recurrence very unusual