Abstract
Introduction: Lumps of the foot present relatively infrequently to the orthopaedic service. There have been very few published studies looking at the differential diagnosis of such lesions and there is no clear evidence for the prevalence of malignant lesions in patients presenting with foot lumps.
Aim: To assess the prevalence of malignant lesions identified in patients presenting with a lump on the foot.
Methods: All patients presenting to a regional centre with a foot lump who required surgical excision of their lesion were identified over a 3 year period. All case notes were retrospectively reviewed. Data recorded included patient demographics, presenting characteristics, pre-operative diagnosis and histological diagnosis The centre includes a tumour service and serves a population of 550,000 patients. Tertiary referrals from out-with the direct catchment area of the centre were excluded.
Results: 101 cases presenting during this study period underwent surgery. Average age was 47.3 years (range 14–79) and there was a significant female preponderance with 73 females and 28 males. There was only one malignant tumour although 32 different histological diagnoses were identified. Only 58 out of the 101 lumps were correctly diagnosed prior to surgery.
Conclusions: We have shown that the prevalence of malignant lesion presenting as foot lumps is low but there are a wide variety of potential diagnoses which have to be considered. Pre-operative diagnosis is often inaccurate, therefore surgical excision and histological diagnosis should still be sought if there is any uncertainty.
Correspondence should be addressed to BOOS at the Royal College of Surgeons, 35 - 43 Lincoln’s Inn Fields, London WC2A 3PN
