Tumors of the Foot and Ankle

Abstract

Tumors involving the foot and ankle are relatively rare. Less than 2% of all sarcomas and less than 10% of soft-tissue sarcomas arise in this location. Pain, swelling, and the presence of a mass are typically diagnosed as the much more common benign tumors, and are treated as such. As a consequence, delays in diagnosis, misdiagnosis, and unplanned surgical excisions lead to poor local control and presumably an increase in systemic disease. Appropriate prebiopsy imaging and a suspicion of malignancy are therefore extremely important. The location and type of biopsy performed are also crucial to optimize treatment. For many soft-tissue sarcomas, chemotherapy is reserved for metastatic disease, or for preoperative reduction of the tumor mass in order to obtain a limb-sparing surgical resection. The impact of long-term survival of patients with soft-tissue sarcomas, with few exceptions, has yet to be proven. Neoadjuvant chemotherapy for primary bone malignancies, Ewing sarcoma, and osteosarcoma, followed by resection with negative margins with limb preservation or amputation, remains the mainstay of treatment.

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