DISORDERS

Cysts and tumors

Ulcers, infection, altered sensation, and collapse of foot architecture are just some examples of the effects of diabetes on the foot.

 

Prevention of soft tissue problems and bony deformities is key and requires a vigilant patient who will cooperate with a dedicated multidisciplinary team approach. In more advanced cases, especially with complications, surgery is often unavoidable.

 

Tumors are lumps of tissue that form when cells divide uncontrollably, and may be benign or malignant. There are a number of different skin, soft tissue and bone tumors that are commonly found in the foot.

 

A very frequent finding is a ganglion cyst, usually painless, and filled with clear fluid. It results from degeneration in an area of the joint capsule or tendon sheath, and thus appear in close relation to a joint. If painful, simple aspiration may be effective.

 

A common benign tumor is a fatty tumor, called a lipoma. The mass is soft and non-tender, but may be painful if it compresses local structures. If there are no symptoms the tumor can be left in place and followed to see if it changes or grows larger over time. Another benign tumor is a fibroma, found on the bottom of the foot near the plantar fascia. If asymptomatic it does not require treatment.

 

A vascular tumor that is found in beneath the nail is a glomus tumor. If it is painful then surgical excision is indicated. Another tumor found in relation to the nail bed is a mucoid cyst, which if not painful should be left undisturbed.

 

One must not assume that every soft movable mass of the foot is benign, as malignant tumors occur with regularity. Melanoma is one of the few primary malignancies that occur on the feet and legs and requires aggressive treatment. Additionally bone tumors may be benign or malignant. The malignant tumors may start in the bone (primary bone tumor) or spread to the foot from another site (metastatic tumors).

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