This learning module is an introduction to the study of bone tumors of the foot.
This learning module introduces the reader to bone tumors of the foot, and explains how the unique anatomy, biology, and biomechanics of the lower extremity play a role in the type of tumors seen in the foot as well as the treatment for them.
The term tumor originates from the latin tumere “to swell” and denotes any type of mass or swelling of bone or soft tissue. Tumors can arise from hamartomas (an overgrowth of normal tissues), reactive or post traumatic processes, inflammatory lesions, or true neoplasms which may be benign or malignant.
The foot is comprised of numerous tightly defined and well vascularized anatomic compartments that predispose to local and distant spread of disease. The clinician examining the patient presenting with a tumor of the foot or ankle must approach the problem in an informed and systematic fashion.
Treatment of benign tumors involves a careful evaluation and biopsy that allows unerring separation of benign processes from malignant ones, followed by surgical removal of the benign tumors by various means, as detailed in what follows.
Treatment of bone sarcomas in the foot and ankle requires avoidance of errors and delays in diagnosis and initial management, as well as a timely and complete work-up and staging of the tumor. Surgery for sarcomas involves resection with a wide margin, plus adjuvant chemotherapy and/or radiotherapy depending on tumor type. In the foot and ankle, adequate resection with a wide margin may require partial or complete amputation of the part.
Limb salvage following removal of tumors in the foot and ankle is complicated by the loads on the skeletal elements and the generally scant soft tissue coverage. The ultimate goal of treatment is elimination of the tumor and restoration of the patient's long-term mobility and function.
