Solar keratoma: An atypical case.
Authors: Miller, Katzwinkel
Journal: Journal of the South African Veterinary Association
Summary
# Editorial Summary: Solar keratoma in bilateral hind feet Keratomas, benign tumours of the hoof horn, are typically regarded as single lesions affecting the forelimbs, yet Miller and Katzwinkel's 2016 case report documents an unusual presentation in a Thoroughbred racehorse that challenges this conventional wisdom. A horse presenting with chronic abscessation and intermittent lameness of the right hind hoof underwent surgical exploration of the draining tract, which revealed a focal mass within the solar horn; histopathological analysis confirmed this as a keratoma, and within months, an identical lesion was identified and removed from the contralateral hind foot. The bilateral and sequential nature of these lesions is atypical, as keratomas are predominantly solitary and more commonly encountered in the forelimbs, making this presentation noteworthy for practitioners managing long-standing hoof-related lameness. For farriers, veterinarians and sports medicine specialists, this case underscores the importance of considering keratoma in the differential diagnosis when confronted with recurrent abscessation, persistent low-grade lameness or draining tracts that resist conventional treatment—particularly where imaging and initial conservative management have proven unrewarding. Surgical exploration and histological confirmation remain essential for diagnosis, and awareness of the potential for bilateral involvement may prompt more thorough examination of the contralateral limb during treatment planning.
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Practical Takeaways
- •For racehorses presenting with chronic hoof abscesses unresponsive to standard treatment, consider keratoma as a differential and advocate for surgical exploration and histopathology
- •Monitor the contralateral hoof closely when keratoma is diagnosed, as bilateral occurrence within months is possible
- •Keratomas can mimic simple abscessation; persistent lameness after apparent drainage warrants deeper investigation of hoof lesions
Key Findings
- •Keratomas can occur bilaterally in hind feet within a short timeframe (masses found in both hind hooves within a few months)
- •Solar keratomas present with long-standing intermittent lameness and abscessation with draining tracts
- •Surgical exploration of chronic hoof abscess tracts revealed a focal keratomatous mass in the solar horn confirmed by histopathology
- •Keratoma should be considered a differential diagnosis for recurrent or long-standing hoof lameness in equine patients