Tumoren des Fußskeletts - Ein Erfahrungsbericht des Hamburger-Knochentumorregisters

Abstract

Aim of the present study was a systematic examination of the tumors of the foot registered in the Hamburg Bone Tumor Registry regarding age, sex, location, diagnosis and morphological characteristics. The registry files and histological specimens of 367 tumors and tumor-like lesions of the foot were reviewed. Males were more frequently affected (ratio 4 : 3). Some 20.4 % of all mass forming tumors were malignant. Cartilage tumors (146 cases), cystic (132 cases) and osteoblastic lesions (33 cases) were most common. Several tumors showed a strong predilection for certain parts of the foot. In the calcaneus a solitary bone cyst was the most common lesion. Lesions in the talus and metatarsals with a similar morphology mostly represented intraosseous ganglion cysts. Other tumors in the calcaneus were mainly cartilaginous. Besides chondroblastoma, chondrosarcoma was regularly diagnosed. Chondroma was extremely rare at this site. Contrary to that chondroma was regularly found at the metatarsal and phalangeal bones, it was 4 times more common than chondrosarcoma. An even distribution showed aneurysmal bone cysts and osteoidosteoma. Very rare lesions were fibrous dysplasia, eosinophilic granuloma and intraosseous lipoma. The knowledge of the distribution of tumors in the foot is important for an exact differential diagnosis and thereby for biopsy planning, diagnosis and therapy.

Distribution patterns of foot and ankle tumors: a university tumor institute experience

“…Many authors fail to provide accurate description of patient selection, for example Pollandt et al noted 4.5% of all musculoskeletal tumors affecting the foot and ankle region, but failed to note the overall number of tumors [ 19 ]. In our study, 413 out of 7847 tumors treated over a period of 18,5 years were located at the foot and ankle, accounting for 5,52% of all tumors.…”

“…Only Ruggieri et al describe a higher incidence from a single centre analysis ( n = 68,8 per year, pseudotumors included). In contrast to many other authors, including some of the largest studies on this subject [ 3 , 4 , 19 ], we excluded pseudotumorous lesions like ganglion cysts or inclusion cysts. Although pseudotumors make up a significant portion of all tumorous lesions of the foot and ankle we intentionally decided to exclude pseudotumorous masses to make future comparative studies more precise and manageable.…”

Do Malignant Bone Tumors of the Foot Have a Different Biological Behavior than Sarcomas at Other Skeletal Sites?

“…They are benign in 75%–85% of cases and malignant in 15%–25% [2, 5, 6]. The bone most commonly affected is the calcaneus, followed by metatarsal and phalangeal bones [1, 7]. Chondrosarcoma is the most frequent malignant tumor of the foot, followed by Ewing sarcoma and osteosarcoma [1, 2].…”

“…However, despite a high rate of misdiagnoses, which may lead to incorrect first-line treatment, foot sarcomas rarely develop metastases [5, 9]. It was hypothesized that this might be due to a less aggressive behavior of bone tumors at the foot compared to other sites of the skeletal system [7, 9]. …”

Recent Developments in the Surgical Treatment of Bone Tumors and Their Impact on Quality of Life

“…A relatively long delay in diagnosis has been reported for tumors of the foot. Additionally, foot sarcomas rarely develop metastases; this may be attributed to a less aggressive behavior of bone tumors at the foot compared to similar histologies in other sites of the skeleton [11–13]. Dr. M. Brotzmann et al studied a series of patients with sarcomas of the foot.…”