Benign Bone Tumors of the Foot - Section 4

[intro][1] [2] [3] [4]

Chondromyxoid fibroma

This relatively rare tumor presents in children and young adults. Three-quarters of patients are younger than 30 and two-thirds are male. This unusual tumor has a striking predilection for the foot. Most tumors occur below the knee and one quarter of the total involve the foot. The metatarsals, midfoot and hindfoot may be involved, with the metatarsals being the most likely site.Patients present with a slow growing mass and mild or moderate pain. Pathological fracture is rare.

Radiographically, the lesion is ovoid in shape with its long axis parallel to the bone. There is often a sclerotic margin and a lobulated contour. Ridges and grooves that appear in the margins secondary to scalloping falsely appear to be trabeculae. CT helps define cortical integrity and confirms that there is no mineralization of the matrix, unlike other cartilage tumors. CMF has the same appearance on MRI as other cartilage tumors which is decreased signal on T 1 weighted images and increased signal on T2 weighted images. MRI is helpful in preoperative planning and staging. The radiologic differential diagnosis includes giant cell tumor, aneurysmal bone cyst, unicameral bone cyst, chondroblastoma and fibrous dysplasia.

Treatment is by curettage and bone grafting. The tumor may recur in the soft tissues from intraoperative seeding so surgeons should take care to avoid tumor spillage into the wound. In the author's experience recurrence is caused by incomplete tumor removal and can be treated with repeat curettage or en bloc resection, if warranted. Surgeons should thoroughly assess the soft tissue extension of the tumor to achieve complete local control.

Unicameral bone cyst

UBC occurs almost exclusively in the calcaneous, and in a highly specific location within this bone. Patients with UBC in the foot present later than usual for this lesion. The authors have seen UBC inpatients as young as 9 and as old as 67.

The location is very specific. The lesion is found under the middle facet with its apex towards the forefoot. On the AP radiograph, it is located in the lateral aspect of the calcaneous. There is no matrix mineralization. The radiographic appearance in similar to that of lipoma of the calcaneous, bu this lesion has a central calcification.

It is likely that many UBC's in the calcaneous remain totally asymptomatic and undiscovered. Treatment is by steroid injection, observation of minimally symptomatic lesions, or by curettage and bone grafting. See treatment of UBC

Back to foot tumors main menu ---->

Back to Bonetumor.org home page ---->

Search for a Tumor Metastatic Tumors Case of the Month Bone Tumor Basics Tumor Jeopardy Fracture Risk Patient's Questions Physician's Questions Physician Referral Meet the Doctor Our Mission You Can Help Us! Email the Webmaster Mailing Address Directions to Hospital UMass Home Page Tips on Using Site Adamantinoma Aneurysmal bone cyst Angiosarcoma - High gd. Bizarre parosteal ost. pro. Brown tumor Chondroblastoma Chondromyxoid fibroma Chondrosarcoma Chordoma Desmoplastic fibroma Enchondroma Eosinophilic granuloma Epithelioid hemangioma Epithelioid hemangioend. Ewing's sarcoma Fibrosarcoma Fibrous dysplasia Florid reactive periostitis Giant cell tumor Glomus tumor Granulocytic sarcoma Hardcastle's syndrome Hemangioma Hemangiopericytoma Juxtacortical chondroma Langerhan's histiocytosis Malignant fibrous histio. Melorheostosis Metastatic cancer menu Multiple myeloma Myositis ossificans Neurofibroma of bone Nora's lesion Osteoblastoma Osteochondroma Osteofibrous dysplasia Osteoid osteoma Osteoma Osteomyelitis Osteopathia striata Osteopoikilosis Osteosarcoma Intro Paget's sarcoma Parosteal osteosarcoma Periosteal osteosarcoma Pigmented villonodular... Schwannoma of bone Solitary bone cyst Synovial chondromatosis Unicameral bone cyst

UBC Images