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Tumors of Foot and Ankle


- Bone Lesions:
    - enchondroma: (relatively common)
    - osteoid osteoma:  (talus, navicular, or calcaneus)
    - fibrous dysplasia
    - adamantinoma (foot)
    - metastatic lung cancer (? GI or GU)
    - osteochondroma
           - subungual exostosis, may develop on a distal phalanx, esp. big toe
           - often there is a history of trauma
           - excision is indicated when elevation of the nail produces pain
           - the history and location of the serve to distinguish it from a osteochondroma;
    - giant cell tumor of bone

- Soft Tissue Lesions:
    - ganglionic cyst: most common lesion in the foot, since this arises from the tarsal joints, it may be necessary to lift up the EDB to see the lesion;
    - melanoma is the most common primary malignant tumor of the foot, occurring most commonly on the plantar skin;
    - synovial sarcoma
    - clear cell sarcoma: upto one half of these tumors occur in the foot;
    - giant cell tumor of tendon sheath
    - fibromatosis:
           - locally aggressive idiopathic proliferative fascitis of the plantar aponeurosis that is usually bilateral;
           - like Dupuytrens's contractures in the hand, this disease (aka Lederhosen syndrome) presents as discrete plantar nodules often seen in non
                   wt bearing areas (esp medial plantar);
           - surgical excision is rarely successful but may be required for large, painful nodules;
                   - excision must include the entire slip of plantar fascia from origin to insertion in order to avoid recurrence rates of up to 60%



Current Concepts Review.  Plantar Fibromatosis.

Soft-tissue tumors and tumor-like lesions of the foot. An analysis of eighty-three cases.

Persistent pain after excision of an interdigital neuroma. Results of reoperation.

Giant-cell reparative granuloma of the hand and foot bones.

Subungual exostoses.

Primary synovial chondromatosis of the ankle. A case report.

Soft tissue tumors of the foot and ankle.

Verrucous carcinoma of the nail bed.  

Tumors of the Foot and Ankle: Experience with 153 Cases