What does a subungual keratoacanthomas look like on radiographs?

VRU 633(6): 675-680

Author

Ryan Appleby
May 23, 2023

Subungual keratoacanthoma (SK): A digital neoplasm that has rarely been reported in dogs and carries an excellent prognosis following surgical removal.

Radiographic features: This retrospective case series aimed to further characterize radiographic findings of histologically confirmed canine SK. Seven dogs met the inclusion criteria, with a total of seven affected digits.

Findings: All seven digits had osteolysis of the distal phalanx’s ungual process and crest, as well as regional soft tissue swelling. Osteolysis of the ungual process was severe in all cases, with complete destruction in six of seven digits. Seven of seven digits had a radiographically thickened claw.

Conclusion: An osteolytic subungual mass should not be considered pathognomonic for malignant neoplasia. Observing the imaging features previously described should prompt veterinarians to consider SK as a differential diagnosis.

Digital radiographic dorsopalmar projection (images A-B) and dorsoplantar projections (images C and D) of canine digits with histologically confirmed subungual keratoacanthomas (SK). Distal phalangeal osteolysis and associated soft tissue swelling are present in these digits. Complete (A, B, and D) to almost complete (C) osteolysis of the ungual process is noted, with complete (A and D) destruction of the ungual crest. A thickened claw can be identified on images (A–D). Focal osteolysis of the distal aspect of the middle phalanx of digit II is associated with adjacent soft-tissue swelling on image (D). Digit V of the dog in image (B) was amputated 5 years prior due to a traumatic nonunion fracture. Technique: kVp 85; mAs 4.8

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