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ankle and foot, leg

A woman with heel pain and a calcaneal tumor

Case Identification
Case ID Number: 
20090710NP
Periosteal Reaction: 
absent
Benign/Malignant: 
unknown
Clinical case information
Case presentation: 

A 31 year old woman who is overweight, with heel pain, ankle pain, flat feet, and a tumor is presented. She is seeking surgical correction of her flat foot deformity on the side with the tumor.

Radiological findings:: 
She has failed orthotics, injections, and physical therapy. A bone lesion is shown in the MRI images. The plain xrays are normal.
Treatment Options:: 
What needs to be done about this lesion? Can surgical treatment of the flatfoot deformity proceed, including osteotomy of the calcaneus, and use of screws to fix the osteotomy?

Acral myxoinflammatory fibroblastic sarcoma - Foot and Ankle

This rare low-grade sarcoma was identified by Meis-Kindblom and Kindblom in 1998.
Patients are in their middle adult years (range third to 9th decade, median 53 years) and males and females are equally affected.
The tumor presents as a painless subcutaneous mass of months or years duration. The lesions average 3 cm in size.MRI exam will demonstrate the extent of the tumor and the regional lymph nodes and chest should be assessed.
Excision with a wide margin and long-term follow-up is required.

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Acral Myxoinflammatory Sarcoma Fibroblástico - Pie y Tobillo

Este sarcoma de bajo grado rara fue identificado por Meis-Kindblom y Kindblom en 1998.
Los pacientes están en su edad adulta media (rango de tercera a novena década, la mediana de años 53) y los hombres y mujeres son igualmente afectados.
El tumor se presenta como una masa indolora de meses o años de duración. Las lesiones promedio de 3 cm de tamaño. Examen de resonancia magnética demostrarán la extensión del tumor y los ganglios linfáticos regionales y el pecho deben ser evaluados.
La escisión con un amplio margen y largo plazo el seguimiento es necesario.

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Adamantinoma

Adamantinoma of the long bones, or extragnathic adamantinoma, is an extremely rare, slow growing, low-grade malignant tumor of epithelial origin, that occurs almost exclusively in the tibia and the fibula.
The tumor usually occurs in the second to fifth decade of life.
The patient usually has swelling that may be painful. The duration of symptoms can vary from a few weeks to years.Adamantinoma appears as an eccentric, well-circumscribed, and lytic lesion on plain x-ray.
Adamantinoma is treated by wide surgical excision

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