Extraskeletal Myxoid

Chondrosarcoma

November 22, 2006

Presented By
Department of Podiatric Surgery
Interfaith Medical Center
 History of Present Illness
• 55 year old Black female with history of
right second toe growth, presents with
pain in the right forefoot.
• Growth in second toe has been increasing
in size over the past six years
• History of stepping on object several years
ago
• No treatment was sought for growth up
until initial presentation
 Past History
• PMH: Asthma
• PSH: denies
• MEDS: denies
• ALLERGIES: Penicillin
• SOCIAL: Smoker 52 pack/yr
• FH- aunt h/o liver Ca
 Physical Examination
• Neurovascular grossly intact to feet
• Non-fluctuant mass lateral aspect of right
second toe extending proximally to medial
aspect of third toe (entire second web space)
• Mass is non-pulsatile
• No edema noted
• No erythema
• No pain with palpation
 Ancillary Tests
• Ancillary Tests Included
– Labs
• all normal
– Radiographs
• inconclusive
– MRI
 Surgical Plan
• Excision of mass
• Frozen section
• Radiograph of right foot to rule out bony
involvement
• Surgical excision of
Multilocular 5 x 4 x 3 cm
mass
• Localized to the second
web space
•R/O granuloma,
neurofibroma, synovial
sarcoma
SURGICAL PATHOLOGY
 Chest CT
• Chest CT to r/o metastasis to lungs,
negative study
 Amputation
• Scheduled for wide excision for clear
margins
• Fish mouth incision
• Amputation of the R foot 2nd and 3rd digits
as well as partial 2nd and 3rd metatarsal
amputations
XRAY
 Extraskeletal myxoid
chondosarcoma
• Usually affects adults in 3rd -5th decade
• Male > female
• Usually deep and intramuscular
• Multinodular tumor c/ fibrous septae