Tumors Of The Foot

There are a number of different skin, soft tissue and bone tumors that are commonly found in the foot. This discussion will be broken into two sections; benign and malignant tumors.

Benign Soft Tissue Tumors of the Foot

Eccrine poroma - This tumor is typically found on the glabrous surface (plantar) of the palms and soles. Eccrine refers to the gland that allows us to perspire.

Etiology - There is no consensus regarding the origin of this tumor but it is thought to represent an occluded sweat gland. Eccrine poromas may be flat or raised, with partial or full discoloration being red or brown.
Symptoms - Symptoms occur with pressure or weight bearing such as the plantar surface of the foot.
Treatment - Conservative care includes periodic debridement of the lesion and surrounding callus.  preferred treatment is curettage or excision under local anesthesia.

Ganglionic cysts - the origin of ganglionic cysts is debated, but these cysts are fluid filled cysts. The most common location for ganglionic cysts in the foot is the lateral side of the arch. (click on link for additional information)

Glomus tumor - a tumor of vascular origin found in the extremities. Often found beneath the nail.

Etiology - Tumors of vascular origin that have an undetermined etiology.
Symptoms - Pain with weight bearing or pressure from shoes.
Treatment - Preferred treatment is excision under local anesthesia. Recurrence is rare.

The following images show the steps used to excise a glomus tumor. Image 1 show pre-operative planning. the glomus tumor is surrounded by 3 blue dots. The remaining images show excision of the tumor and closure of the wound.

Intractable plantar keratoma - this benign soft tissue tumor is actually a unique form of callus. This callus forms a core beneath a weight bearing surface such as the plantar surface of a metatarsal head. (click on link for additional information)

Etiology - Load bearing on the skin.
Symptoms - Pain with weight bearing.
Treatment - Periodic debridement or metatarsal osteotomy. A metatarsal osteotomy is a procedure where the load bearing bone (metatarsal) is intentionally broken in a surgical procedure that mimics a stress fracture.

Mucoid cyst - Also known as a myxoid cyst, periungual ganglion, mucinous cyst. Many authors believe that the gelatinous contents of this cyst arise from the synovial lining of an adjacent tendon or joint. These cysts are common and are often found adjacent to the nails on the fingers and toes.

Etiology - Unknown - believed to be due to a herniation of an adjacent tendon or joint space.
Symptoms - Pain with weight bearing.
Treatment - Periodic aspiration or wide excision.

Etiology - Unknown.
Symptoms - Pain secondary to expansion of the synovium with pressure against adjacent tissue and nerve.
Treatment - Excision.

Plantar fibromatosis - plantar fibromatosis (PF) is a fairly aggressive benign tumor of the plantar fascia. The plantar fascia is a broad band that runs from the plantar aspect of the calcaneus (heel bone) to the plantar aspect of the metatarsal phalangeal joints (toe joints). (click on link for additional information)

Synovial cysts - fluid filled tumors that arise from structures that contain synovial lining such as the interior surface of a joint or tendon. (click on link for additional information)

Malignant Tumors of the Foot

Malignant melanoma - this aggressive tumor may be found virtually anywhere on the body and is one of the few primary malignancies found on the feet and legs. The rate of malignant melanoma has doubled over the past 30 years with an estimated 53,000 new cases being diagnosed in the United States alone each year. Although malignant melanoma accounts for only 1% of all reported skin cancers, it accounts for over 60% of all skin cancer deaths. It metastasized early and its' metastases are difficult to treat.

For many types of malignant melanoma, the 5 year survival rate is very poor with typical metastasis to the bone or liver. Several different forms of malignant melanoma are known.

Etiology - Dysplasia of the melanocytes.
Symptoms - Pain with irritation or weight bearing.  Early lesions are often asymptomatic.
Treatment - A combination of surgical, radiation therapy and/or chemotherapy.

Kaposi's Sarcoma - vascular tumor that may appear in three distinct forms; (1) indolent, (2) lymphadenopathy and (3) Acquired immune deficiency syndrome.

Etiology - Mixed vascular structures.
Symptoms - Indolent - painful lesions of the foot and leg. The lymphadenopathy form shows wide dissemination in the lymph system.
Treatment - combination of surgical excision, radiation and chemotherapy.

Squamous cell carcinoma - this is a slow growing form of epidermal cancer that is typically limited to area of excessive sun exposure. Squamous cell Cancer is the second most common form of skin cancer second only to basal cell carcinoma.

Etiology - Dysplasia of the epidermis, commonly associated with sun exposure.
Symptoms - The formation of plaque called actinic or senile keratoses.
Treatment - Primary excision with or without chemotherapy.

Melanocytes - a cell giving pigmentation to the skin.

Metatarsal - one of five bones of each foot that extends from the mid arch to the metatarsal phalangeal joints (toe joints).

Osteotomy - to make a surgical break of a bone.

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No information is available for this topic.

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• Ingrown Toe Nail

• Mortons Neuroma

• Plantar Fibromatosis

• Bursitis

• Ganglionic Cyst

This article was written by Jeffrey A. Oster, DPM and last updated 2/8/13. No additional information is available for this topic.