Bone tumours of the foot & ankle: an analysis of 131 cases

T. Ankers, T. Paavana, B. Trevor, C. Heaver, P. Cool

Background: Bone tumours are a broad group of conditions that may present to foot and ankle surgeons. They range from benign problems requiring only reassurance, to rare but potentially life-threatening conditions. In this study we summarise the typical features of bones tumours of the foot and ankle. By doing so we aim to help medical professionals identify and triage lesions at the earliest possible opportunity.

Methods: A retrospective review of cases presenting to a specialist bone tumour unit was undertaken. Inclusion criteria were primary bone tumours, both benign and malignant, metastases and haematological cancers. Excluded were tumour mimickers such as infection. Data on patient demographics, presentation, investigations including histology and subsequent management were collected.

Results: 131 cases were included between 25th March 2010 and 23rd February 2023. Mean follow up was 15 weeks. There were 99 benign lesions and 32 malignant lesions. The most common benign lesions were enchondroma, osteochondroma and osteoid osteoma. Malignant lesions included 9 cases of metastasis, 6 cases of lymphoma and 17 primary malignant bone tumours. This latter group comprised 9 chondrosarcomas, 4 Ewings sarcomas and 4 osteosarcomas. Surgery was the mainstay of treatment for malignant primary bone tumours. There were 4 deaths with a 1 year survival of 87.5% and 3 year survival of 75%.

Conclusion: Thankfully the majority of bone tumours of the foot and ankle are benign however the morbidity and mortality associated with malignant lesions is high. A delay in diagnosis may compromise management options or lead to an avoidable death. A high index of suspicion and early discussion with a tumour centre is recommended.