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plantar fibroma

Plantar Fibroma/Fibromatosis. Fibroma:Benign, self-liming proliferation of fibroblasts, producing collagen, most being subcutaneous single lesionsOccur at any ageLesions may recur after excision. Plantar Fibroma/Fibromatosis. Fibromatosis:Group of diseases demonstrating infiltrative growth that makes them less discrete than fibromasMultiple lesionsAffects medial fascial slip.

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plantar fibroma

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    1. PLANTAR FIBROMA/FIBROMATOSIS: A CASE PRESENTATION ERIC BEATTY, DPM

    3. Plantar Fibroma/Fibromatosis Fibromatosis: Group of diseases demonstrating infiltrative growth that makes them less discrete than fibromas Multiple lesions Affects medial fascial slip

    4. Plantar Fibroma/Fibromatosis Possible Onset: Aggressive healing response to small tears in the plantar fascia (over repair) Congenital deformity Secondary to history of puncture injuries to the foot

    5. Plantar Fibroma/Fibromatosis A 56 y/o female presents with complaint of left foot pain for duration >6 months Palpable nodule on left medial plantar arch Progressed gradually in size Painful upon ambulation, palpation, and shoe gear Previous conservative treatment ineffective

    6. Plantar Fibroma/Fibromatosis PMH: HTN PSH: c-section, fibroid surgery, tonsilectomy, tubal ligation Meds: atenolol 25mg, MVI, calcium supplement Allergies: penicillin Social Hx: negative Etoh/Tobacco: negative Height: 51 Weight: 164 lb

    7. Plantar Fibroma/Fibromatosis Observation: 3cm subcutaneous soft tissue mass just proximal to the 1st metatarsal head extending into the mid arch area of the medial plantar surface of left foot.

    8. Plantar Fibroma/Fibromatosis

    9. Plantar Fibroma/Fibromatosis Differential Diagnosis: Foreign objects Dermatofibroma (a fibroma of the skin) Abscess Neuroma Histiocytoma Fibrosarcoma (rare in foot)

    10. Plantar Fibroma/Fibromatosis Diagnostic Imaging: Ultrasound Nodules are hypoechoic and appear as droplets of wate adhering to the plantar surface of the fascia MRI T1-weighted spin-echo (low signal intensity) T2-weighted spin-echo (low to intermediate signal intensity)

    11. Plantar Fibroma/Fibromatosis MRI T1-weighted spin-echo (low signal intensity)

    12. Plantar Fibroma/Fibromatosis MRI T2-weighted spin echo images (low to intermediate signal intensity)

    13. Plantar Fibroma/Fibromatosis Ultrasound (nodule is hypoechoic and appear as droplets of water)

    14. Plantar Fibroma/Fibromatosis Procedure: Curvilinear incision over plantar palpable mass Sharp/blunt dissection Mass noted adhered to plantar fascia (medial band) Excised in toto (6cmx2cm) Smaller fibromas noted in soft tissue (medial plantar fascia band) Excision of medial plantar fascia band to prevent recurrence

    15. Plantar Fibroma/Fibromatosis Procedure cont. Closed with 3.0 vicryl/4.0 nylon NWB with crutches for 3 weeks

    16. Plantar Fibroma/Fibromatosis Pathology: Benign plantar fibromatosis left foot

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