Left Plantar growth

[Angela]

Hi Steve, i saw this lump a few weeks ago. It was a left plantar growth for about 3 years adjacent to big toe medial aspect. Pain when exercising or running. Stumped on what it could be. I have attached some images for you to review

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[Stephen Bird]

Great case Angela,

It does not look like a dermal based lesion to me.

It is a bit too deep and the vascularity is not typical of a dermal lesion.

I think the most likely diagnosis is a nerve sheath tumour.

Either a neurofibroma or schwannoma.

It has a typical shape and echo texture for one of these and also the vascularity is typical.

There branches f the medial plantar nerve pass through that anatomical location,

So I am suggesting it is a medial plantar nerve branch, nerve sheath tumour as my number 1 differential.

I have seen this before,

Ask if they have neurofibromatosis as this is a link, but even if not it can be one.

Time for an MRI scan to see if we are right!

Unfortunately a soft tissue sarcoma has to also be included on the differential list, but I think this is less likely (but not impossible).

The MRI will give the answer.

Thanks so much for posting it.

Steve.

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