Skip to main content
SpringerLink
Log in

Tumors of the Foot and Ankle

  • Chapter
  • First Online:
Foot and Ankle Disorders

  • 1795 Accesses

Abstract

Musculoskeletal neoplasms in the foot and ankle are overall infrequent clinical conditions. This being said, lesions in this area tend to cause symptoms early during their presentation, thus causing patients to seek medical attention. As in other locations of the body, most bone and soft tissue tumors within the foot and ankle will be benign; however, even in non-malignant disease, local management of active or aggressive lesions can be challenging given the segment’s complexity and the size and proximity of different structures. Similarly, malignant tumors (sarcomas or metastatic disease) can cause rapid bone and soft tissue destruction, making reconstruction alternatives scarce. In order to achieve adequate outcomes, it is crucial for every specialist involved in these patients’ care to be familiar with the general principles of the diagnosis and management of musculoskeletal tumors within the foot and ankle. This chapter gives emphasis on the most common histologies and their management, with particular attention to clinical presentation, evaluation, early referral, and initial treatment.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 139.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 179.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 249.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Bos GD, Esther RJ, Woll TS. Foot tumors: diagnosis and treatment. Vol. 10, The Journal of the American Academy of Orthopaedic Surgeons. 2002. p. 259–70.

    Google Scholar 

  2. Toepfer A, Harrasser N, Recker M, Lenze U, Pohlig F, Gerdesmeyer L, et al. Distribution patterns of foot and ankle tumors: A university tumor institute experience. BMC Cancer. 2018;18(1).

    Google Scholar 

  3. Khan Z, Hussain S, Carter SR. Tumours of the foot and ankle. Vol. 25, Foot. 2015. p. 164–72.

    Google Scholar 

  4. Davis AM, Kandel RA, Wunder JS, Unger R, Meer J, O’Sullivan B, et al. The impact of residual disease on local recurrence in patients treated by initial unplanned resection for soft tissue sarcoma of the extremity. J Surg Oncol. 1997;66(2):81–7.

    Google Scholar 

  5. Chou LB, Ho YY, Malawer MM. Tumors of the foot and ankle: Experience with 153 cases. Foot Ankle Int. 2009;30(9):836–41.

    Google Scholar 

  6. George A, Grimer R. Early symptoms of bone and soft tissue sarcomas: could they be diagnosed earlier? Ann R Coll Surg Engl. 2012;94:261.

    Article  CAS  Google Scholar 

  7. Evans S, Ramasamy A, Jeys L, Grimer R. Delayed diagnosis in metastatic lesions of the foot. Ann R Coll Surg Engl. 2014;96:536.

    Article  CAS  Google Scholar 

  8. Grimer RJ, Briggs TWR. Earlier diagnosis of bone and soft-tissue tumors. J Bone Joint Surg Br. 2010;92:1489.

    Article  CAS  Google Scholar 

  9. Miller BJ. Use of Imaging Prior to Referral to a Musculoskeletal Oncologist. Vol. 27, Journal of the American Academy of Orthopaedic Surgeons. 2019. p. E1001–8.

    Google Scholar 

  10. Nagano S, Yahiro Y, Yokouchi M, Setoguchi T, Ishidou Y, Sasaki H, et al. Doppler ultrasound for diagnosis of soft tissue sarcoma: Efficacy of ultrasound-based screening score. Radiol Oncol. 2015;49(2):135–40.

    Google Scholar 

  11. Harrison DJ, Parisi MT, Shulkin BL. The Role of 18F-FDG-PET/CT in Pediatric Sarcoma. Vol. 47, Seminars in Nuclear Medicine. 2017. p. 229–41.

    Google Scholar 

  12. Wu Q, Yang R, Zhou F, Hu Y. Comparison of whole-body MRI and skeletal scintigraphy for detection of bone metastatic tumors: A meta-analysis. Vol. 22, Surgical Oncology. 2013. p. 261–6.

    Google Scholar 

  13. Mankin HJ, Mankin CJ, Simon MA. The hazards of the biopsy, revisited: For the members of the musculoskeletal tumor society. J Bone Jt Surg - Ser A. 1996;78(5):656–63.

    Google Scholar 

  14. De Marchi A, Brach Del Prever EM, Linari A, Pozza S, Verga L, Albertini U, et al. Accuracy of core-needle biopsy after contrast-enhanced ultrasound in soft-tissue tumours. Eur Radiol. 2010;20(11):2740–8.

    Google Scholar 

  15. Shin HJ, Amaral JG, Armstrong D, Chait PG, Temple MJ, John P, et al. Image-guided percutaneous biopsy of musculoskeletal lesions in children. Pediatr Radiol. 2007;37(4):362–9.

    Google Scholar 

  16. Ogilvie CM, Torbert JT, Finstein JL, Fox EJ, Lackman RD. Clinical utility of percutaneous biopsies of musculoskeletal tumors. Clin Orthop Relat Res. 2006 Sep;450:95-100.

    Google Scholar 

  17. Biscaglia R, Bacchini P, Bertoni F. Giant cell tumor of the bones of the hand and foot. Cancer. 2000;88(9):2022–32.

    Google Scholar 

  18. About the Foot and Ankle. Vol. 56, Radiologic Clinics of North America. 2018. p. 917–34.

    Google Scholar 

  19. Osman W, Jerbi M, Ben Abdelkrim S, Maaref K, Ben Maitigue M, Ben Ayèche ML. Giant cell tumor of the lower end of tibia. Curettage and cement reconstruction. Foot Ankle Surg. 2015;21(1):e16–20.

    Google Scholar 

  20. Campanacci M, Baldini N, Boriani S, Sudanese A. Giant-cell tumor of bone. J Bone Jt Surg - Ser A. 1987;69(1):106–14.

    Google Scholar 

  21. Rajani R, Schaefer L, Scarborough MT, Gibbs CP. Giant Cell Tumors of the Foot and Ankle Bones: High Recurrence Rates After Surgical Treatment. J Foot Ankle Surg. 2015;54(6):1141–5.

    Google Scholar 

  22. Fink BR, Temple HT, Chiricosta FM, Mizel MS, Murphey MD. Chondroblastoma of the foot. Foot Ankle Int. 1997;18(4):236–42.

    Google Scholar 

  23. Angelini A, Arguedas F, Varela A, Ruggieri P. Chondroblastoma of the Foot: 40 Cases From a Single Institution. J Foot Ankle Surg. 2018;57(6):1105–9.

    Google Scholar 

  24. Reda B. Cystic bone tumors of the foot and ankle. Vol. 117, Journal of Surgical Oncology. 2018. p. 1786–98.

    Google Scholar 

  25. Ramappa AJ, Lee FYI, Tang P, Carlson JR, Gebhardt MC, Mankin HJ. Chondroblastoma of bone. J Bone Jt Surg - Ser A. 2000;82(8):1140–5.

    Google Scholar 

  26. Oliveira AM, Chou MM. USP6-induced neoplasms: The biologic spectrum of aneurysmal bone cyst and nodular fasciitis. Hum Pathol. 2014;45(1):1–11.

    Google Scholar 

  27. Park HY, Yang SK, Sheppard WL, Hegde V, Zoller SD, Nelson SD, et al. Current management of aneurysmal bone cysts. Vol. 9, Current Reviews in Musculoskeletal Medicine. 2016. p. 435–44.

    Google Scholar 

  28. Chowdhry M, Chandrasekar CR, Mohammed R, Grimer RJ. Curettage of aneurysmal bone cysts of the feet. Foot Ankle Int. 2010;31(2):131–5.

    Google Scholar 

  29. Rhee Y, Lee JD, Shin KH, Lee HC, Huh KB, Lim SK. Oncogenic osteomalacia associated with mesenchymal tumour detected by indium-111 octreotide scintigraphy. Clin Endocrinol (Oxf). 2001 Apr;54(4):551–4.

    Google Scholar 

  30. Chun KA, Stephanie S, Choi JY, Nam JH, Suh JS. Enchondroma of the Foot. J Foot Ankle Surg. 2015;54(5):836–9.

    Google Scholar 

  31. Zamora T, Urrutia J, Schweitzer D, Amenabar PP, Botello E. Do Orthopaedic Oncologists Agree on the Diagnosis and Treatment of Cartilage Tumors of the Appendicular Skeleton? Clin Orthop Relat Res. 2017;475(9):2176–86.

    Google Scholar 

  32. Kitsoulis P, Galani V, Stefanaki K, Paraskevas G, Karatzias G, Agnantis NJ, et al. Osteochondromas: Review of the clinical, radiological and pathological features. Vol. 22, In Vivo. 2008. p. 633–46.

    Google Scholar 

  33. Bernard SA, Murphey MD, Flemming DJ, Kransdorf MJ. Improved differentiation of benign osteochondromas from secondary chondrosarcomas with standardized measurement of cartilage cap at CT and MR imaging. Radiology. 2010;255(3):857–65.

    Google Scholar 

  34. Schulze S C, Valenzuela G G, Zamora H T. Manejo expectante de osteocondroma solitario interóseo de la tibia distal: reporte de un caso y revisión de la literatura. Rev Chil Ortop y Traumatol. 2018;59(03):100–4.

    Google Scholar 

  35. Levy DM, Gross CE, Garras DN. Treatment of Unicameral Bone Cysts of the Calcaneus: A Systematic Review. Vol. 54, Journal of Foot and Ankle Surgery. 2015. p. 652–6.

    Google Scholar 

  36. Aumar DK, Dadjo YBA, Chagar B. Intraosseous Lipoma of the Calcaneus: Report of a Case and Review of the Literature. J Foot Ankle Surg. 2013;52(3):360–3.

    Google Scholar 

  37. Chow LTC, Lee KC. Intraosseous lipoma: A clinicopathologic study of nine cases. Am J Surg Pathol. 1992;16(4):401–10.

    Google Scholar 

  38. Narang S, Gangopadhyay M. Calcaneal intraosseous lipoma: A case report and review of the literature. J Foot Ankle Surg. 2011;50(2):216–20.

    Google Scholar 

  39. Gouin F, Noailles T. Localized and diffuse forms of tenosynovial giant cell tumor (formerly giant cell tumor of the tendon sheath and pigmented villonodular synovitis). Vol. 103, Orthopaedics and Traumatology: Surgery and Research. 2017. p. S91–7.

    Google Scholar 

  40. Noailles T, Brulefert K, Briand S, Longis PM, Andrieu K, Chalopin A, et al. Giant cell tumor of tendon sheath: Open surgery or arthroscopic synovectomy? A systematic review of the literature. Vol. 103, Orthopaedics and Traumatology: Surgery and Research. 2017. p. 809–14.

    Google Scholar 

  41. Mastboom MJL, Palmerini E, Verspoor FGM, Rueten-Budde AJ, Stacchiotti S, Staals EL, et al. Surgical outcomes of patients with diffuse-type tenosynovial giant-cell tumours: an international, retrospective, cohort study. Lancet Oncol. 2019;20(6):877–86.

    Google Scholar 

  42. Staals EL, Ferrari S, Donati DM, Palmerini E. Diffuse-type tenosynovial giant cell tumour: Current treatment concepts and future perspectives. Vol. 63, European Journal of Cancer. 2016. p. 34–40.

    Google Scholar 

  43. Carroll P, Henshaw RM, Garwood C, Raspovic K, Kumar D. Plantar Fibromatosis: Pathophysiology, Surgical and Nonsurgical Therapies: An Evidence-Based Review. Vol. 11, Foot and Ankle Specialist. 2018. p. 168–76.

    Google Scholar 

  44. Aluisio F V., Mair SD, Hall RL. Plantar fibromatosis: treatment of primary and recurrent lesions and factors associated with recurrence. Foot Ankle Int. 1996 Nov;17(11):672-8.

    Google Scholar 

  45. Knebel C, Neumann J, Schwaiger BJ, Karampinos DC, Pfeiffer D, Specht K, et al. Differentiating atypical lipomatous tumors from lipomas with magnetic resonance imaging: A comparison with MDM2 gene amplification status. BMC Cancer. 2019;19(1).

    Google Scholar 

  46. Zeytoonjian T, Mankin HJ, Gebhardt MC, Hornicek FJ. Distal lower extremity sarcomas: Frequency of occurrence and patient survival rate. Foot Ankle Int. 2004;25(5):325–30.

    Google Scholar 

  47. Branford-White H, Giele H, Critchley P, Cogswell L, Gibbons CLM, Dean BJF, et al. Management and outcome of acral soft-tissue sarcomas. Bone Jt J. 2018;100B(11):1518–23.

    Google Scholar 

  48. Cribb GL, Loo SCS, Dickinson I. Limb salvage for soft-tissue sarcomas of the foot and ankle. J Bone Jt Surg - Ser B. 2010;92(3):424–9.

    Google Scholar 

  49. Blscaglia R, Gasbarrini A, Böhling T, Bacchini P, Bertoni F, Picci P. Osteosarcoma of the bones of the foot-an easily misdiagnosed malignant tumor. Mayo Clin Proc. 1998;73(9):842–7.

    Google Scholar 

  50. Mascard E, Gaspar N, Brugières L, Glorion C, Pannier S, Gomez-Brouchet A. Malignant tumours of the foot and ankle. EFORT Open Rev. 2017;2(5):261–71.

    Google Scholar 

  51. Verdegaal SHM, Brouwers HFG, Van Zwet EW, Hogendoorn PCW, Taminiau AHM. Low-grade chondrosarcoma of long bones treated with intralesional curettage followed by application of phenol, ethanol, and bone-grafting. J Bone Jt Surg - Ser A. 2012;94(13):1201–7.

    Google Scholar 

  52. Schreuder HWB, Pruszczynski M, Veth RPH, Lemmens JAM. Treatment of benign and low-grade malignant intramedullary chondroid tumours with curettage and cryosurgery. Eur J Surg Oncol. 1998;24(2):120–6.

    Google Scholar 

  53. DuBois SG, Krailo MD, Gebhardt MC, Donaldson SS, Marcus KJ, Dormans J, et al. Comparative evaluation of local control strategies in localized Ewing sarcoma of bone: A report from the Children’s Oncology Group. Cancer. 2015;121(3):467–75.

    Google Scholar 

  54. Chung TS. Metastatic malignancy to the bones of the hand. J Surg Oncol. 1983;24(2):99–102.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Orthopaedic Oncology and Lower Limb Reconstructive Surgery, Orthopaedic Surgery Department, Pontificia Universidad Católica de Chile, Santiago, Chile

    Eduardo Botello & Tomas Zamora

Authors
  1. Eduardo Botello
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Tomas Zamora
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Eduardo Botello .

Editor information

Editors and Affiliations

  1. Orthopedic Surgery Department, Clínica Alemana de Santiago - Universidad del Desarrollo, Santiago, RM - Santiago, Chile

    Emilio Wagner Hitschfeld

  2. Orthopedic Surgery Department, Clínica Alemana de Santiago - Universidad del Desarrollo, Hospital Militar de Santiago – Universidad de los Andes, Santiago, RM - Santiago, Chile

    Pablo Wagner Hitschfeld

Rights and permissions

Reprints and permissions

Copyright information

© 2022 The Author(s), under exclusive license to Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Botello, E., Zamora, T. (2022). Tumors of the Foot and Ankle. In: Wagner Hitschfeld, E., Wagner Hitschfeld, P. (eds) Foot and Ankle Disorders. Springer, Cham. https://doi.org/10.1007/978-3-030-95738-4_4

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-95738-4_4

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-95737-7

  • Online ISBN: 978-3-030-95738-4

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation