Abstract
Introduction
Bony tumours of foot account for approximately 3% of osseous tumours. However, literature regarding calcaneal tumours comprises individual case reports, short case series or literature reviews, with last large case series in 1973. Literature on bony tumours of the talus is limited to case reports only.
Methods
We retrospectively reviewed medical notes and imaging for all patients with calcaneal or talar tumours recorded in the Scottish Bone Tumour Registry since the 1940's. Demographics, presentation, investigation, histology, management and outcome were reviewed.
Results
38 calcaneal tumours and 24 talar tumours were identified.
Calcaneal tumours
Mean age at presentation 30 with heel pain and swelling, average length of symptoms 9 months. 4 cases present with pathological fracture. 24 tumours benign including 6 unicameral bone cysts, 3 chondroblastoma, 3 PVNS with calcaneal erosion, and wide variety of individual lesions. 13 malignant tumours comprising 6 osteosarcoma, 5 chondrosarcoma and 2 Ewing's sarcoma. 1 metastatic carcinoma.
Talar Tumours
Mean age at presentation 28 with ankle pain and occasionally swelling, average length of symptoms 5 months. 20 benign cases including 7 osteoid osteoma, 4 chondroblastoma, and variety of individual lesions. 3 malignant lesions comprising 2 chondrosarcoma, one osteosarcoma
Discussion
Tumours of hindfoot frequently are delayed in diagnosis due to rarity and lack of clinician familiarity. They are more common in men especially talar tumours which are most commonly benign osteoid osteoma or chondroblastoma. Calcaneal tumours have 1 in 3 risk of malignancy. Diagnosis is often made on plain radiograph but MRI is the gold standard.
Conclusion
We present largest case series of calcaneal tumours and first case series of talar tumours from the Scottish Bone Tumour Registry. Despite their rarity clinicians should maintain a high index of suspicion as accurate and timely diagnosis is important to management and outcome.
