Tumours

Like elsewhere in the body tumours may be benign or malignant, which may be primary or secondary. The foot shows three types of benign tumour: those that are latent or active, and finally those which are locally invasive but do not metastasise.

Primary malignancy is relatively rare but can arise in any of the tissues which go to make up the structure of the foot. They are usually graded on the basis of their differentiation, whether they cross anatomical barriers and obviously whether they have metastasised. More common are metastases from the common malignant tumours: lung, breast and prostate.

Plain X-rays can be helpful, but for thorough preoperative analysis of a tumour, investigations such as computerised tomography (CT) scans, technetium bone scans, MRI scans and high-resolution ultrasound for the vascular tumours may be necessary. Serological studies and investigations such as chest X-rays looking for evidence of distant spread may be required.

Treatment

This may involve simple local excision through to amputation, depending on the nature and extent of the tumour. In the foot it is particularly important to take into account the local anatomy when planning tumour excision.