Assessment of the Pediatric Foot Mass

Abstract

Masses in the pediatric foot are relatively uncommon and can present a diagnostic challenge. The literature lacks a comprehensive overview of these types of lesions. Most are benign soft-tissue lesions that can be diagnosed on the basis of history and physical examination. However, some rare malignant neoplasms can mimic benign masses. It is imperative to recognize these lesions because the consequences of a delayed or missed diagnosis can be substantial. A thorough history and physical examination of all pediatric patients with foot lesions are crucial to ensure that any lesion not readily identified as benign is appropriately managed.

Soccer player with painful toe

“…2 Exostosis represents 10% to 15% of all benign bone tumors, making it the most common benign bone tumor. 3 Generally, the age of occurrence is 10 to 15 years. 3 ❚ Repetitive trauma can be a culprit.…”

“…3 Generally, the age of occurrence is 10 to 15 years. 3 ❚ Repetitive trauma can be a culprit. Up to 8% of exostoses occur in the foot, with the most commonly affected area being the distal medial portion of the big toe.…”

“…Up to 8% of exostoses occur in the foot, with the most commonly affected area being the distal medial portion of the big toe. 3,4 Repetitive trauma and infection are potential risk factors. 3,4 The affected toe may be painful, but that is not always the case.…”

“…3,4 Repetitive trauma and infection are potential risk factors. 3,4 The affected toe may be painful, but that is not always the case. 4 Typically, lesions are solitary; however, multiple lesions can occur.…”

“…Benign soft-tissue masses make up the over-whelming majority of pediatric foot lesions, accounting for 61% to 87% of all foot lesions. 3 Malignancies such as chondrosarcoma can occur and can be difficult to diagnose. Rapid growth, family history, size > 5 cm, heterogenous appearance on magnetic resonance imaging, and poorly defined margins are a few characteristics that should increase suspicion for possible malignancy.…”