Tumors of the foot and ankle: analysis of a 10 years’ experience from a large UK tumor center

R. Colta, V. Sethurajah, C. Loizou, M. Rogers, B. Sharp, R. Brown

Introduction: Among the musculoskeletal system, tumors localized to the foot and ankle are not common. Most tumors of the foot and ankle will be benign, and it has been easy for clinicians to underestimate the malignant potential of a given tumor. The purpose of our study was to describe the largest UK experience with different tumor types of the foot and ankle, who underwent surgical excision, from a single tumor center over a 10 years' period.

Methods: A retrospective review was performed using the clinical records of all patients with histologically confirmed musculoskeletal tumors of the foot and ankle, treated between 2010 and 2019 at our institution. The data was analyzed regarding epidemiologic information, entity and localization. Included were all cases with a true tumor of the foot and ankle. Exclusion criteria were incomplete information on the patient’s histopathological diagnosis, infection and inflammatory conditions.

Results: Our series included 496 patients of which 31.6% were men, with an overall mean age at diagnosis of 46.7 years. Overall 457 lesions (92.1%) were nonmalignant and 39 (7.9%) were malignant. Soft tissue lesions were diagnosed in 456 cases (91.9%), out of which 422 (92.5 %) were benign. Bone lesions were diagnosed in 40 cases (8.1%) out of which 5 (12.5 %) were malignant. 25.6 % of the tumors were localized at the ankle and 74.4% at the foot level.

Conclusion: Foot and ankle tumors are rare compared with many other lesions, and physicians approaching a patient with foot and ankle lesions should always include malignant neoplastic disease in the differential diagnosis. Knowledge of incidence and distribution patterns of foot and ankle tumors will help to correctly assess unclear masses and initiate the right steps in further diagnostics and treatment. Unawareness can lead to delayed diagnosis and inadequate treatment with serious consequences for patients.