Clinical investigations demonstrate that malignant neoplasms, although very rare in general, are more frequently localized at the foot than generally assumed. The foot and ankle region, which represents about 3% of the total body mass, is affected by bone neoplasms in 3-5% of all tumor cases.
Soft tissue tumors in the foot region are even more frequently represented. 5% of all malignant and 8% of all benign soft tissue tumors can be found at the foot. The average age at the time of diagnosis lies between 20 and 30 years but ranges from early childhood to the late senior age. Overall there is no clear gender preference. Regarding localization, the calcaneus and the metatarsalia are most frequently affected by bone tumors. Soft-tissue tumors can be found anywhere on the foot.
In our own investigation of more than 400 foot and ankle tumors, the most common benign bone tumors were simple bone cyst, enchondroma, and aneurysmal bone cyst. The most common malignant bone tumors were chondrosarcoma (Fig.1), osteosarcoma and Ewing’s sarcoma. Soft tissue benign tumors most commonly found were hemangioma, teno-synovial giant cell tumor (PVNS) (Fig.4), and schwannoma. Benign soft tissue tumors showed a very broad spectrum of entities. The most common malignant soft-tissue tumors were of synovial sarcomas, melanoma and pleomorphic sarcoma.
These different distribution patterns show how heterogeneous the clinical picture „foot tumor“ really is.
In clinical practice, this means that foot tumors must be analyzed with particular attention.