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Tumors of the Foot and Ankle

Aggressive digital papillary adenoma / adenocarcinoma - Foot and Ankle

Aggressive digital papillary adenocarcinoma is a rare cutaneous tumor of eccrine sweat gland origin that occurs on the plantar surfaces of the digits in the hand and foot.
This tumor affects men more than women, with a mean age at presentation of 52 yrs (range: 19-83 yrs).
It can have an indolent clinical course without symptoms or change for years. The average tumor size is 1.7 cm and the mas may be present from 2 months to 15 years. Pain is a frequent presenting complaint.
Aggressive surgical re-resection or amputation if necessary to avoid local recurrence.

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A 36 year old woman with a "thick foot"

Case Identification
Case ID Number: 
20110317TF
Benign/Malignant: 
unknown
Clinical case information
Case presentation: 

This active and fit 36 year old woman has been practicing mixed martial arts and kickboxing. She says her right foot has been "thick" and swollen for about 6 months.

Radiological findings:: 
A soft tissue mass in the plantar aspect of the foot, dark on T1 and bright on T2, measures about 12 by 6 by 6 centimeters.
Laboratory results:: 
No labs were needed.
Differential Diagnosis: 
Soft tissue tumors, benign and malignant
Further Work Up Needed:: 
What additional physical examination steps should be taken? What imaging exams are needed to complete the work-up?
Pathology results:: 
See the images shown from the biopsy material. The immunohistochemistry images demonstrate that the tumor stains postitive for keratin (not shown), and positive for EMA (see image).

A Cartilage Mass in the mid foot

Case Identification
Case ID Number: 
20100810CM
Benign/Malignant: 
unknown
Clinical case information
Case presentation: 

A 78 year old man has a slowly growing, slightly painful, palpable nodular mass in the TMT joint of the 1st ray.

Radiological findings:: 
The mass is dark on T1, bright on T2. It surrounds the joint on all sides.

A lawyer with a mass on the leg for 18 months - treatment

Case Identification
Case ID Number: 
20090825LM
Benign/Malignant: 
Malignant
Clinical case information
Case presentation: 

The patient had an incisional biopsy, and the findings are shown. The initial treatment is shown.

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