Tumors and Tumor-Like Lesions of the Foot and Ankle: Diagnosis and Treatment

  • Hans Gollwitzer
  • Andreas K. Toepfer
  • Ludger Gerdesmeyer
  • Reiner Gradinger
  • Hans Rechl


Bone and soft tissue tumors of the foot and ankle are not rare in the foot specialist’s practice. Although masses are usually seen early with early symptoms due to compact anatomy with thin soft tissue coverage (e.g., pain on weight-bearing), diagnosis is often delayed. Diagnostic errors are more common than in other regions, since neoplasia is often not considered. Tumor size is a major prognostic factor for recurrence-free survival, and delayed diagnosis finally results in undertreatment or overtreatment with serious consequences. Thus, if early diagnosis is compelled, prognosis is generally improved.


Bone Tumor Soft Tissue Masse Synovial Sarcoma Soft Tissue Tumor Giant Cell Tumor 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. 1.
    Dahlin DC, Unni KK, eds. Bone Tumors: General Aspects and Data on 8,542 Cases. 4th ed. Springfield: Charles C. Thomas; 1986.Google Scholar
  2. 2.
    Kransdorf MJ. Benign soft-tissue tumors in a large referral population: distribution of specific diagnoses by age, sex, and location. AJR Am J Roentgenol. 1995;164:395-402.PubMedGoogle Scholar
  3. 3.
    Gerrand CH, Wunder JS, Kandel RA, et al. The Influence of anatomic location on functional outcome in lower-extremity soft-tissue sarcoma. Ann Surg Oncol. 2005;11:476-482.CrossRefGoogle Scholar
  4. 4.
    Chou LB, Ho YY, Malawer MM. Tumors of the foot and ankle: experience with 153 cases. Foot Ankle Int. 2009;30:836-841.PubMedCrossRefGoogle Scholar
  5. 5.
    Ozdemir MH, Yildiz Y, Yilmaz C, Saglik Y. Tumors of the foot and ankle: analysis of 196 cases. J Foot Ankle Surg. 1997;36:403-408.PubMedCrossRefGoogle Scholar
  6. 6.
    Albreski D, Sloan SB. Melanoma of the feet: misdiagnosed and misunderstood. Clin Dermatol. 2009;27(6):556-563.PubMedCrossRefGoogle Scholar
  7. 7.
    Bancroft LW, Peterson JJ, Kransdorf MJ. Imaging of soft tissue lesions of the foot and ankle. Radiol Clin North Am. 2008;46(6):1093-1103.PubMedCrossRefGoogle Scholar
  8. 8.
    Llauger J, Palmer J, Monill JM, Franquet T, Bagué S, Rosón N. MR imaging of benign soft-tissue masses of the foot and ankle. Radiographics. 1998;18(6):1481-1498.PubMedGoogle Scholar
  9. 9.
    Campanacci M, ed. Bone and Soft Tissue Tumors. 2nd ed. Padova: Piccin Nuova Libraria and Wien, New York: Springer; 1999.Google Scholar
  10. 10.
    Johnson PT, Fayad LM, Frassica FJ, Fishman EK. Computed tomography of the bones of the foot: neoplastic disease. J Comput Assist Tomogr. 2009;33(3):436-443.PubMedCrossRefGoogle Scholar
  11. 11.
    De Schepper AM, De Beuckeleer L, Vandevenne J, Somville J. Magnetic resonance imaging of soft tissue tumors. Eur Radiol. 2000;10:213-222.PubMedCrossRefGoogle Scholar
  12. 12.
    Rhee JH, Lewis RB, Murphey MD. Primary osseous tumors of the foot and ankle. Magn Reson Imaging Clin N Am. 2008;16(1):71-91.PubMedCrossRefGoogle Scholar
  13. 13.
    Waldt S, Rechl H, Rummeny EJ, Woertler K. Imaging of benign and malignant soft tissue masses of the foot. Eur Radiol. 2003;13(5):1125-1136.PubMedGoogle Scholar
  14. 14.
    Woertler K. Soft tissue masses in the foot and ankle: characteristics on MR Imaging. Semin Musculoskelet Radiol. 2005;9(3):227-242.PubMedCrossRefGoogle Scholar
  15. 15.
    Mankin HJ, Lange TA, Spanier SS. The hazards of biopsy in patients with malignant primary bone and soft-tissue tumors. J Bone Joint Surg Am. 1982;64:1121-1127.PubMedGoogle Scholar
  16. 16.
    Mankin HJ, Mankin CJ, Simon MA. The hazards of the biopsy, revisited. Members of the Musculoskeletal Tumor Society. J Bone Joint Surg Am. 1996;78:656-663.PubMedGoogle Scholar
  17. 17.
    Huch K, Röderer G, Ulmar B, Reichel H. CT-guided interventions in orthopedics. Arch Orthop Trauma Surg. 2007;127:677-683.PubMedCrossRefGoogle Scholar
  18. 18.
    Enneking WF. A system of staging musculoskeletal neoplasms. Clin Orthop Relat Res. 1986;204:9-24.PubMedGoogle Scholar
  19. 19.
    Capanna R, Sudanese A, Baldini N, Campanacci M. Phenol as an adjuvant in the control of local recurrence of benign neoplasms of bone treated by curettage. Ital J Orthop Traumatol. 1985;11(3):381-388.PubMedGoogle Scholar
  20. 20.
    Lack W, Lang S, Brand G. Necrotizing effect of phenol on normal tissues and on tumors. A study on postoperative and cadaver specimens. Acta Orthop Scand. 1994;65(3):351-354.PubMedCrossRefGoogle Scholar
  21. 21.
    Malawer MM, Dunham W. Cryosurgery and acrylic cementation as surgical adjuncts in the treatment of aggressive (benign) bone tumors. Clin Orthop Relat Res. 1991;262:42-57.PubMedGoogle Scholar
  22. 22.
    Ruiz Santiago F, Del Mar Castellano García M, Guzmán Álvarez L, Martínez Montes JL, Ruiz García M, Tristán Fernández JM. Percutaneous treatment of bone tumors by radiofrequency thermal ablation. Curr Rev Musculoskelet Med. 2009;2(1):43-50.CrossRefGoogle Scholar
  23. 23.
    Volkmer D, Sichlau M, Rapp TB. The use of radiofrequency ablation in the treatment of musculoskeletal tumors. J Am Acad Orthop Surg. 2009;17(12):737-743.PubMedGoogle Scholar
  24. 24.
    Simon CJ, Dupuy DE. Percutaneous minimally invasive therapies in the treatment of bone tumors: thermal ablation. Semin Musculoskelet Radiol. 2006;10(2):137-144. Epub 2006 Apr 5.PubMedCrossRefGoogle Scholar
  25. 25.
    Erickson JK, Rosenthal DI, Zaleske DJ, Gebhardt MC, Cates JM. Primary treatment of chondroblastoma with percutaneous radio-frequency heat ablation: report of three cases. Radiology. 2001;221(2):463-468.PubMedCrossRefGoogle Scholar
  26. 26.
    Rybak LD, Rosenthal DI, Wittig JC. Chondroblastoma: radiofrequency ablation – alternative to surgical resection in selected cases. Radiology. 2009;251(2):599-604.PubMedCrossRefGoogle Scholar
  27. 27.
    Ahrar K. The role and limitations of radiofrequency ablation in treatment of bone and soft tissue tumors. Curr Oncol Rep. 2004;6(4):315-320.PubMedCrossRefGoogle Scholar
  28. 28.
    Murari TM, Callaghan JJ, Berrey BH Jr, Sweet DE. Primary benign and malignant osseous neoplasms of the foot. Foot Ankle. 1989;10:68-80.PubMedGoogle Scholar
  29. 29.
    Fox C, Husain ZS, Shah MB, Lucas DR, Saleh HA. Chondroblastic osteosarcoma of the cuboid: a literature review and report of a rare case. J Foot Ankle Surg. 2009;48(3):388-393.PubMedCrossRefGoogle Scholar
  30. 30.
    Berliner RA, Guadara J, Adelman H, Conforti J, Uhm K. Extraosseous Ewing’s sarcoma in the foot. J Foot Ankle Surg. 1995;34(3):301-304.PubMedCrossRefGoogle Scholar
  31. 31.
    El Ghazaly SA, DeGroot H III. Metastases to bones of the foot: a case series, review of the literature, and a systematic approach to diagnosis. Foot Ankle Spec. 2008;1(6):338-343.PubMedGoogle Scholar
  32. 32.
    Kirby EJ, Shereff MJ, Lewis MM. Soft-tissue tumors and tumor-like lesions of the foot. An analysis of eighty-three cases. J Bone Joint Surg Am. 1989;71:621-626.PubMedGoogle Scholar
  33. 33.
    Robbin MR, Murphey MD, Temple HT, Kransdorf MJ, Choi JJ. Imaging of musculoskeletal fibromatosis. Radiographics. 2001;21(3):585-600.PubMedGoogle Scholar
  34. 34.
    Brewster MB, Power D, Sumathi VP. Delayed diagnosis of synovial sarcoma of the foot. Orthopedics. 2008;31(2):175.PubMedCrossRefGoogle Scholar
  35. 35.
    Scully SP, Temple HT, Harrelson JM. Synovial sarcoma of the foot and ankle. Clin Orthop Relat Res. 1999;364:220-226.PubMedCrossRefGoogle Scholar
  36. 36.
    Malchau SS, Hayden J, Hornicek F, Mankin HJ. Clear cell sarcoma of soft tissues. J Surg Oncol. 2007;95(6):519-522.PubMedCrossRefGoogle Scholar
  37. 37.
    Sara AS, Evans HL, Benjamin RS. Malignant melanoma of soft parts (clear cell sarcoma). A study of 17 cases, with emphasis on prognostic factors. Cancer. 1990;65(2):367-374.PubMedCrossRefGoogle Scholar
  38. 38.
    Potter BK, Pitcher JD Jr, Adams SC, Temple HT. Squamous cell carcinoma of the foot. Foot Ankle Int. 2009;30:517-523.PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag London Limited 2012

Authors and Affiliations

  • Hans Gollwitzer
    • 1
  • Andreas K. Toepfer
    • 2
  • Ludger Gerdesmeyer
    • 3
  • Reiner Gradinger
    • 4
  • Hans Rechl
    • 5
  1. 1.Klinik für Orthopädie und Sportorthopädie, Klinikum rechts der IsarTechnische Universität MünchenMunichGermany
  2. 2.Klinik für Orthopädie und UnfallchirurgieTechnische Universität MünchenMunichGermany
  3. 3.Department of Orthopaedic and Trauma SurgeryMare Klinikum KielKiel-KronshagenGermany
  4. 4.Clinic for Orthopaedics and Traumatology, Klinikum rechs der IsarTechnische Universität MünchenMunichGermany
  5. 5.Klinik für Orthopädie und UnfallchirurgieTechnische Universität MünchenMunichGermany

Personalised recommendations