Benign and malignant tumors of the foot and ankle

Singer, Adam D.; Datir, Abhijit; Tresley, Jonathan; Langley, Travis; Clifford, Paul D.; Jose, Jean; Subhawong, Ty K.

doi:10.1007/s00256-015-2278-2

Cited by 38 publications

(58 citation statements)

References 50 publications

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“…11,15 It can show the size, situation and vascularity of soft-tissue tumours, but in all suspected tumours (benign or not) it is mandatory to perform at least an MRI before any surgery. 18 In soft-tissue tumours, echography of the whole limb will assess lymphatic node extension of the disease.…”

Section: Imagingmentioning

confidence: 99%

“…On MRI, the ossified matrix will be seen as a low signal on all pulse sequences while the soft-tissue tumour can be heterogeneous with varying signal intensity and enhancement depending on the degree of haemorrhage and necrosis (Fig.3). 11,15 …”

Section: Malignant Bone Tumoursmentioning

confidence: 99%

“…It is the second most common malignant bone tumour in children and 80% of patients are aged less than 20 years. It is characterised by a recurrent chromosomal translocation t 11,22 detectable in approximately 85% of cases. 22 It occurs rarely in the foot, but is the most common malignancy of feet bones in children.…”

Section: Malignant Bone Tumoursmentioning

confidence: 99%

“…Larger tumours may demonstrate the classic ‘triple sign’ (low, intermediate and high signal intensity on long TR pulse sequences due to the presence of fibrous tissues, calcium, haemorrhage and necrosis). 11,15 …”

Section: Soft-tissue Malignant Tumoursmentioning

confidence: 99%

“…The plantar compartment is divided into three parts, separated by thin aponeuroses, crossed by tendons and vascular bundles making the extensive spread of tumours easier and therefore large resections difficult to achieve. 11 …”

Section: Introductionmentioning

confidence: 99%

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Malignant tumours of the foot and ankle

et al. 2017

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Most of tumours of the foot are tumour-like (synovial cyst, foreign body reactions and epidermal inclusion cyst) or benign conditions (tenosynovial giant cells tumours, planta fibromatosis). Malignant tumours of the soft-tissue and skeleton are very rare in the foot and their diagnosis is often delayed with referral to specialised teams after initial inappropriate procedures or unplanned excisions. The adverse effect of these misdiagnosed tumours is the increasing rate of amputation or local recurrences in the involved patients. In every lump, imaging should be discussed before any local treatment. Every lesion which is not an obvious synovial cyst or plantar fibromatosis should have a biopsy performed.After the age of 40 years, chondrosarcoma is the most usual malignant tumour of the foot. In young patients bone tumours such as osteosarcoma or Ewing’s sarcoma, are very unusually located in the foot. Synovial sarcoma is the most frequent histological diagnosis in soft tissues. Epithelioid sarcoma or clear cell sarcoma, involve more frequently the foot and ankle than other sites. The classic local treatment of malignant conditions of the foot and ankle was below-knee amputation at different levels. Nowadays, with the development of adjuvant therapies, some patients may benefit from conservative surgery or partial amputation after multidisciplinary team discussions.The prognosis of foot malignancy is not different from that at other locations, except perhaps in chondrosarcoma, which seems to be less aggressive in the foot. The anatomy of the foot is very complex with many bony and soft tissue structures in a relatively small space making large resections and conservative treatments difficult to achieve.Cite this article: EFORT Open Rev 2017;2. DOI: 10.1302/2058-5241.2.160078. Originally published online at www.efortopenreviews.org

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Section: Imagingmentioning

confidence: 99%

Section: Malignant Bone Tumoursmentioning

confidence: 99%

Section: Malignant Bone Tumoursmentioning

confidence: 99%

Section: Soft-tissue Malignant Tumoursmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Malignant tumours of the foot and ankle

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Surgical excision of complex lipoma from the foot: A case report

Uddin

Flanagan

Reilly

2022

Clinical Case Reports

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Malignant soft tissue tumors of the foot and ankle are rare but diagnostic imaging and/or interventional biopsy are vital to establish the nature and grading of a suspicious tumor prior to definitive surgical intervention. The purpose of the study is to provide an account on how a symptomatic mass of the plantar aspect of the foot warranted a referral to a sarcoma center, highlighting the importance of having access to diagnostic imaging and a pathway to refer suspected cases to specialist centers. A single patient with a symptomatic soft tissue tumor of the plantar foot was referred from our service to the regional sarcoma center who considered to be benign, and therefore, open surgical resection was performed by our team. Histopathological analysis identified the excised mass as a lipoma. At 2 years, postoperatively there was no recurrence, and the patient presented with an asymptomatic foot. United Kingdom (UK) guidelines suggest that all soft tissue masses of suspicious nature, greater than 50 mm, deep seated irrespective of size, or fast growing lesions should be referred to a sarcoma unit prior to surgical management. European guidance identifies a threshold of 15 mm for a mass in the foot. Patients presenting with red flag symptoms irrespective of size of mass should be referred to a sarcoma center. Advanced imaging and multidisciplinary input to enable appropriate surgical planning is recommended for suspicious soft tissue tumors that present to the foot and ankle surgeon.

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