EFORT Open Rev 2017 May 11;2(5):261-271. Epub 2017 May 11.

Laboratoire d'anatomie et cytologie pathologiques, Institut Universitaire du Cancer de Toulouse- Oncopole, 1 avenue Irène Joliot-Curie. 31059 Toulouse Cedex 9, France.

Most of tumours of the foot are tumour-like (synovial cyst, foreign body reactions and epidermal inclusion cyst) or benign conditions (tenosynovial giant cells tumours, planta fibromatosis). Malignant tumours of the soft-tissue and skeleton are very rare in the foot and their diagnosis is often delayed with referral to specialised teams after initial inappropriate procedures or unplanned excisions. The adverse effect of these misdiagnosed tumours is the increasing rate of amputation or local recurrences in the involved patients. Read More

Foot (Edinb) 2017 Jun 21;31:31-34. Epub 2017 Feb 21.

Royal Liverpool and Broadgreen University Hospitals NHS Trust, Prescot Street, Liverpool, L7 8XP, United Kingdom.

Plantar fibromatosis is a rare, benign fibroproliferative disorder of the plantar fascia. It is considered as a low-grade tumour and it can be locally aggressive. It can present as painful swelling with impairment of local function. Read More

Arthrosc Tech 2016 Dec 5;5(6):e1387-e1393. Epub 2016 Dec 5.

Department of Orthopaedics and Traumatology, North District Hospital, Hong Kong SAR, China.

Plantar fibromatosis is a rare benign but often locally aggressive tumor of the plantar aponeurosis. Nonsurgical treatment is the first line of treatment for symptomatic lesions. Because of the high recurrence rate associated with surgical treatment, operation is indicated only when the lesions are highly symptomatic and conservative measures fail or the diagnosis is in question. Read More

J Clin Rheumatol 2017 Jan;23(1):63-65

Department of Physical and Rehabilitation Medicine, University of PadovaPadova, Italy.

Insights Imaging 2017 Feb 12;8(1):69-78. Epub 2016 Dec 12.

Radiology Department, Fondazione IRCCS Policlinico San Matteo, Università degli Studi di Pavia, Pavia, Italy.

Plantar fascia (PF) disorders commonly cause heel pain and disability in the general population. Imaging is often required to confirm diagnosis. This review article aims to provide simple and systematic guidelines for imaging assessment of PF disease, focussing on key findings detectable on plain radiography, ultrasound and magnetic resonance imaging (MRI). Read More

Am J Dermatopathol 2017 Mar;39(3):e38-e40

*Department of Medicine (DIMED), Surgical Pathology Unit, University of Padua, Padua, Italy; †Pathology Unit, Veneto Institute of Oncology, IOV-IRCCS, Padua, Italy; and ‡Clinic of Plastic Surgery, University of Padua, Padua, Italy.

Extraskeletal myxoid chondrosarcoma (EMC) is a rare soft tissue sarcoma usually presenting in proximal extremities of middle-aged men. The authors discuss a unique case of EMC, localized in the plantar foot of a 76-year-old woman, clinically suspected as plantar fibromatosis. It is important to avoid misdiagnosis of EMC because of their propensity for late recurrence and their metastatic potential. Read More

Acta Dermatovenerol Croat 2016 Jun;24(2):148-9

Aslı Aksu Çerman, MD, Şişli Hamidiye Etfal Training and Research Hospital, Dermatology Department, Halaskargazi Cad, Etfal S, Istanbul, Turkey;

Connective tissue nevi (CTN) are dermal hamartomas characterized by an imbalance in the amount and distribution of the normal components of the extracellular dermal matrix, specifically collagen, elastin, and/or proteoglicans. The term "CTN" was first mentioned by Lewandowsky in 1921 (1), although it was not accepted until the review by Gutmann in 1926 (2). Classification of CTN was established by Uitto et al. Read More

Joint Bone Spine 2017 May 17;84(3):371-372. Epub 2016 Jun 17.

Rheumatology Department, Clermont-Ferrand Teaching Hospital, place Henri-Dunant, 63000 Clermont-Ferrand, France.

Pain Med 2016 Oct 7;17(10):1965-1966. Epub 2016 Apr 7.

Department of Physical and Rehabilitation Medicine, Hacettepe University Medical School, Ankara, Turkey.

Case Rep Orthop 2015 10;2015:509732. Epub 2015 Dec 10.

Faculty of Medical Sciences and Health of Juiz de Fora (FCMS/JF - SUPREMA), BR 040, km 796, Salvaterra, 36045-410 Juiz de Fora, MG, Brazil; Hospital e Maternidade Therezinha de Jesus, Rua Doutor Dirceu de Andrade 33, São Mateus, 36025-140 Juiz de Fora, MG, Brazil.

Plantar fibromatosis, Ledderhose's disease, or Morbus Ledderhose is an uncommon benign nodular hyperplasia of the plantar aponeurosis. The aim of this paper was to report the case of a 47-year-old male patient who had concomitant Dupuytren's disease and failed all conservative measures. He was treated surgically with prompt and complete relief of symptoms postoperatively, and he has had no recurrence at the 2-year follow-up. Read More

Indian Dermatol Online J 2015 Nov-Dec;6(6):422-4

Ackerman Academy of Dermatopathology, New York, USA.

Ledderhose disease, or plantar fibromatosis, is a benign hyperproliferative disorder of the plantar aponeurosis. It presents as one or more round, firm slow-growing plaques or nodules on the plantar surface of the foot, typically on the medial side. The etiology is unknown, though it has been associated with trauma, liver disease, diabetes mellitus, epilepsy and alcoholism. Read More

J Orthop Sci 2016 May 29;21(3):395-8. Epub 2015 Jun 29.

Department of Orthopaedic Surgery, Teikyo University School of Medicine, 2-11-1, Kaga, Itabashi, Tokyo 173-8605, Japan.

Anticancer Res 2015 Nov;35(11):6171-4

Department of Pathology and Immunology, Baylor College of Medicine, Houston, TX, U.S.A.

Background: Extraskeletal myxoid chondrosarcoma is a rare tumor with an indolent course, high propensity for local recurrence, metastases, and propensity for the proximal extremities of middle-aged males.

Case Report: We present the case of a 44-year-old man with an extraskeletal myxoid chondrosarcoma in the plantar fascia of the medial arch initially thought to be a plantar fibroma. Magnetic resonance imaging of the lesion demonstrated a lobulated subcutaneous mass plantar to the tarsal bones and inseparable from the fascia. Read More

Case Rep Orthop 2015 6;2015:741461. Epub 2015 Sep 6.

Service d'Imagerie Médicale, CHU Saint-Pierre, 1000 Bruxelles, Belgium.

Plantar fibromatosis, or Ledderhose disease, is a rare hyperproliferative disorder of the plantar aponeurosis. It may occur at any age, with the greatest prevalence at middle age and beyond. This disorder is more common in men than woman and it is sometimes associated with other forms of fibromatosis. Read More

Pract Radiat Oncol 2015 Nov-Dec;5(6):e651-8. Epub 2015 Jul 2.

Department of Radiation Oncology, Virginia Commonwealth University, Richmond, Virginia.

Purpose: Palmar and plantar fibromatosis (PPF) is a progressive connective tissue disorder of the hand/foot that often leads to debilitating functional impairment. In Europe, orthovoltage radiation therapy (RT) has been demonstrated to prevent local disease progression for up to 80% of patients with early-stage PPF. There are limited data reporting outcomes for populations outside of Europe or using electron RT. Read More

J Eur Acad Dermatol Venereol 2016 Jul 24;30(7):1133-5. Epub 2015 Aug 24.

Department of Dermatology, Universitair Ziekenhuis Brussel, (UZ Brussel), Vrije Universiteit Brussel (VUB), Laarbeeklaan 101, Brussels, Belgium.

Background: The BRAF-inhibitor vemurafenib, used in patients with metastatic melanoma, induces multiple cutaneous side-effects.

Objective: The aim of this work was to evaluate the development of palmoplantar fibromatosis in a population of patients treated with the BRAF inhibitor vemurafenib.

Methods: Between April 2011 and February 2013, we initiated a treatment with vemurafenib in 53 patients with an unresectable stage IIIC or stage IV melanoma. Read More

Nucl Med Commun 2015 Sep;36(9):881-6

aDepartment of Radiology, Division of Nuclear Medicine, St Louis University bSaint Louis VA Medical Center, Saint Louis, Missouri, USA cNational Cancer Institute, Cairo University, Cairo, Egypt.

Plantar pain is a common problem endured by most adults at some point in their life that may result in considerable disability. Plantar fibromatosis is a locally invasive neoplasm, with the development of fibrous nodules on the plantar aspect of the feet, which can remain asymptomatic for years. (18)F-Fluorodeoxyglucose ((18)F-FDG) PET/CT has been more prevalent as the imaging modality of choice for cancer patients, but the imaged field of view is often from the base of the skull to the upper thighs. Read More

J Am Podiatr Med Assoc 2015 Mar;105(2):135-40

Background: One of the most common causes of heel pain is plantar fasciitis; however, there are other pathologic disorders that can mimic the symptoms and clinical presentation of this disorder. The purpose of this study was to retrospectively review the prevalence of various pathologic disorders on ultrasound in patients with proximal plantar heel pain.

Methods: The medical records and diagnostic ultrasound reports of patients presenting with plantar heel pain between March 1, 2006, and March 31, 2007, were reviewed retrospectively, and the prevalence of various etiologies was collected. Read More

Plast Reconstr Surg 2014 Sep;134(3):497e-498e

Department of Surgery, Wayne State University, 4201 St. Antoine, 6C-UHC, Detroit, Mich. 48201,

BMJ Case Rep 2014 Aug 14;2014. Epub 2014 Aug 14.

Centre for Clinical and Diagnsotic Oral Sciences, Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.

J Orthop Traumatol 2014 Sep 24;15(3):225-9. Epub 2014 Jun 24.

Patankar's Hand and Limb Reconstruction Clinic, 204, Garodia Market, Plot no. 8-A, D.K. Sandu Marg, Chembur, Mumbai, 400071, Maharashtra, India.

Background: Soft tissue defects over the mid- and distal third tibia, heel, dorsum and plantar aspect of the foot and over the medial, lateral and posterior aspect of the ankle are a common scenario in clinical orthopaedic practice. In this article, we describe the utility of the reverse sural fasciocutaneous flap with a cutaneous pedicle in 109 clinical cases with distal lower limb soft tissue defects.

Materials And Methods: A total of 109 patients were operated on for moderate (5-15 cm) and large (more than 15 cm) soft tissue defects at various sites along the lower limb including foot, heel and sole with the reverse sural fasciocutaneous flap. Read More

Pediatr Radiol 2014 Oct 13;44(10):1281-9. Epub 2014 May 13.

Hospital Universitaio y Politécnico La Fe, Valencia, Spain,

Background: Ablation techniques are widely used for solid malignant tumors in adults. There is no large series assessing the effectiveness of local ablative therapies in the treatment of malignant or aggressive benign lesions in children.

Objective: To review the existing evidence on the techniques and results of ablation for pediatric solid malignant or aggressive benign tumors. Read More

J Med Imaging Radiat Oncol 2014 Oct 14;58(5):641-7. Epub 2014 Apr 14.

Department of Radiation Oncology, Royal Adelaide Hospital, Adelaide, South Australia, Australia; Adelaide Radiotherapy Centre, Adelaide, South Australia, Australia.

Introduction: Palmar and plantar fascial fibromatoses are benign hyperproliferative disorders of the deep fascia of the palm and sole. This study seeks to examine the role of radiotherapy in the management of fascial fibromatosis.

Method: Six consecutive cases of early-stage fascial fibromatosis treated with radiotherapy at the Adelaide Radiotherapy Centre between July 2008 and May 2011 were analysed. Read More

Diagn Interv Imaging 2014 Sep 11;95(9):893-6. Epub 2014 Mar 11.

Department of Radiology, Angers University Hospital, 4, rue Larrey, 49933 Angers, France.

Cutis 2013 Nov;92(5):220, 225, 226

Dermatopathology Laboratory, 6255 Sheridan Dr, Building B, Ste 208, Williamsville, NY 14221, USA.

Skeletal Radiol 2014 Mar 10;43(3):403-7. Epub 2013 Oct 10.

Harvard Medical School, 250 Longwood Avenue, Boston, MA, 02115, USA,

Soft tissue angiofibroma is a recently described neoplasm that typically presents as a slowly growing, painless mass in the soft tissues of the lower extremities. Cytogenetic and molecular studies have identified a recurrent t(5;8) translocation. Treatment is simple excision. Read More

Foot Ankle Int 2013 Dec 16;34(12):1742-6. Epub 2013 Sep 16.

Institute of Anatomy, Saarland University, Homburg, Germany.

Morbus Ledderhose is a rare hyperproliferative disease of the plantar fascia, leading to the formation of nodules. Its origin is unknown. No causal therapy is available, and treatment remains symptomatic. Read More

Orthopedics 2013 Sep;36(9):e1209-12

Extra-abdominal periosteal desmoid tumors are uncommon nonmetastatic tumors of the extremities with a propensity for local recurrence. Lesions in the distal extremities are rare; a majority of extra-abdominal lesions occur in more proximal portions of the upper and lower extremities. This article reports a patient with an extra-abdominal periosteal desmoid tumor in the toe. Read More

Foot (Edinb) 2013 Jun-Sep;23(2-3):88-92. Epub 2013 Feb 14.

Radiologie Ostéo-Articulaire, Hôpital Lariboisière, 2 rue Ambroise Paré, 75475 Paris Cedex 10, France. Electronic address:

We report the case of a 42-year-old man with histologically proven plantar fibromatosis (Ledderhose disease) demonstrating an uncommon brain gyriform pattern at MRI, so far exclusively described in the low-grade fibromyxoid sarcoma (LGFMS). An acoustic posterior enhancement at ultrasound, a high intensity on T2w and post-contrast T1wMR images were unusual and related to a high tumor cellularity at histology with no myxoid tissue. The juxtaposition of areas of high and low cellularity (with more fibrous material) in a multilobulated mass built a brain gyriform pattern at MR, similar to what was so far described exclusively in LGFMS. Read More

Przegl Lek 2012 ;69(9):663-6

Klinika Medycyny Ratunkowej i Obrazeń, Wielonarzadowych, Kraków.

Introduction: Ledderhose's disease is a rare fibromatosis affecting plantar aponeurosis. Clinical picture and risk factors resemble the ones found in much more common cases of Dupuytren's disease.

Material And Methods: The group of 101 patients with Dupuytren's disease qualified for surgical treatment constituted material for the study. Read More

Foot Ankle Int 2013 Jun 5;34(6):841-5. Epub 2013 Feb 5.

Reykjavik Primary Health Care, Glaesibaer, 104 Reykjavik, Iceland.

Background: Fibromatous nodules in the sole of the foot are often called Ledderhose disease. It is a benign nodular formation in the plantar aponeurosis, typically at the distal medial border. A lump forms and it can be a few centimeters in diameter. Read More

BMC Res Notes 2012 Oct 2;5:542. Epub 2012 Oct 2.

Plastic, Hand and Reconstructive Surgery, Burn Center, Hannover Medical School, Carl-Neuberg-Str 1, Hannover 30625, Germany.

Background: Plantar fibromatosis is a benign disease creating nodules on the medial plantar side of affected patients. While surgical removal is regarded as the therapeutic mainstay, recurrence rates and impairment of daily activities remains substantial. High-energy focussed extracorporeal shockwave therapy has been suggested to be potentially effective in plantar fibromatosis in terms of pain reduction. Read More

Sarcoma 2012 28;2012:215810. Epub 2012 Jun 28.

Department of Radiology, Penn State Milton S. Hershey Medical Center, Penn State College of Medicine, 500 University Drive, Hershey, PA 17033, USA.

The fibromatoses are a group of benign fibroblastic proliferations that vary from benign to intermediate in biological behavior. This article will discuss imaging characteristics and patient demographics of the adult type superficial (fascial) and deep (musculoaponeurotic) fibromatoses. The imaging appearance of these lesions can be characteristic (particularly when using magnetic resonance imaging). Read More

Ann Rehabil Med 2011 Aug 31;35(4):507-13. Epub 2011 Aug 31.

Department of Rehabilitation Medicine, Bundang Jesaeng General Hospital, Seongnam 463-774, Korea.

Objective: The objectives of this study were to investigate the causes of plantar heel pain and find differences in the clinical features of plantar fasciitis (PF) and fat pad atrophy (FPA), which are common causes of plantar heel pain, for use in differential diagnosis.

Method: This retrospective study analyzed the medical records of 250 patients with plantar heel pain at the Foot Clinic of Rehabilitation Medicine at Bundang Jesaeng General Hospital from January to September, 2008.

Results: The subjects used in this study were 114 men and 136 women patients with a mean age of 43. Read More

Rheumatology (Oxford) 2012 Jun 12;51(6):1134-6. Epub 2012 Feb 12.

Vojnosanit Pregl 2011 Oct;68(10):886-90

Klinicki center Vojvodine, Klinika za plasticnu i rekonstruktivnu hirurgiju, Novi Sad, Srbija.

Background: Fibromatosis represents a wide group of benign, locally proliferative disorders of fibroblasts. Dupuytren's disease is a benign proliferative disease of palmar aponeurosis which usually affects adults between 40 and 60 years of age. Ledderhose's disease or plantar fibromatosis is plantar equivalent of Dupuyten's disease most often affecting middle-aged and older men, usually bilateral, represented with painless nodule in the medial division of plantar fascia. Read More

Med Hypotheses 2011 May 1;76(5):635-7. Epub 2011 Feb 1.

Plastic, Hand and Reconstructive Surgery, Hannover Medical School, Germany.

Dupuytren's disease is a progressive disease due to unknown causal agents or genetics. An epidemiological analysis of 566 cases in North Germany estimated that around 1.9 million Germans are suffering from Dupuytren's disease. Read More

Acta Chir Orthop Traumatol Cech 2010 Aug;77(4):341-5

Klinika ortopedie a traumatologie pohybového ústrojí FN a LF UK Plzeň.

The authors describe the concomitant presence of plantar fibromatosis and Dupuytren's disease in a 33-year-old man. A lesion located under the sesamoid bones of the first metatarsophalangeal joint on the right showed an aggressive tendency (rapid growth, pain, impossibility to put weight on the medial side of the foot). Another lesion located proximal to the first one was smaller and painless. Read More

J Clin Aesthet Dermatol 2010 Sep;3(9):45-7

Plantar fibromatosis, or Ledderhose disease, is a rare hyperproliferative disorder of the plantar aponeurosis. It may occur at any age with the greatest prevalence at middle age and beyond. This disorder is more common in men than woman and it is sometimes associated with other forms of fibromatosis. Read More

Acta Oncol 2011 Apr 30;50(3):455-61. Epub 2010 Aug 30.

Sarcoma Unit, Royal Marsden Hospital, London, United Kingdom.

Background: Aggressive fibromatosis (AF) is a locally invasive proliferative disease. The mainstay of treatment is surgery. Chemotherapy may be considered in inoperable AF following failure of hormonal therapy and/or NSAIDs. Read More

Strahlenther Onkol 2010 Jan 28;186(1):24-9. Epub 2009 Dec 28.

Department of Radiotherapy, Klinikum Offenbach, Offenbach, Germany.

Purpose: To evaluate the efficacy of radiation therapy (RT) in the treatment of early stages of benign plantar fibromatosis (Morbus Ledderhose [ML]).

Patients And Methods: From 2003 to 2008, 24 patients (33 sites) with a mean age of 52 years received RT for symptomatic ML. Prior to RT, 19 patients complained of pain and 15 had walking difficulties. Read More

BMJ Case Rep 2010 Sep 20;2010. Epub 2010 Sep 20.

Department of Plastic and Reconstructive Surgery, Complejo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, Spain.

Dupuytren's disease is a palmar fascia pathology characterised by flexion contracture of the involved fingers in late stages. It has been described a higher prevalence in northern populations, especially in men in the fifth or sixth decade of life.1 Alcohol consumption, liver disease, diabetes mellitus, epilepsy and some of its treatments, tobacco smokers or hand workers are only a example of the different aetiologies proposed. Read More

Radiographics 2009 Nov;29(7):2143-73

Department of Radiologic Pathology, Armed Forces Institute of Pathology, Building 54, Room M-133A, Washington, DC 20306, USA.

Musculoskeletal fibromatoses represent a wide spectrum of fibroblastic and myofibroblastic neoplasms with similar pathologic appearances and variable clinical behavior. These lesions can be categorized by location (superficial or deep) or by the age group predominantly affected. Superficial fibromatoses in adults (palmar and plantar) and children (calcifying aponeurotic fibroma, lipofibromatosis, and inclusion body fibromatosis) are often small slow-growing lesions; their diagnosis is suggested by location. Read More

Am J Orthop (Belle Mead NJ) 2009 Sep;38(9):475-6

Department of Radiology, Miller School of Medicine, University of Miami, Miami, Florida 33136, USA.

Eur J Cancer 2009 Nov 18;45(17):2930-4. Epub 2009 Sep 18.

Sarcoma Unit, Royal Marsden Hospital, Fulham Rd, London SW3 6JJ, UK.

Background: Aggressive fibromatosis (AF) or desmoid tumour is a monoclonal proliferation which is locally invasive but does not metastasize. If local treatment fails to control the disease, systemic treatment with anti-oestrogens, non-steroidal anti-inflammatory drugs (NSAIDs) or chemotherapy can be used. Recent reports indicate that pegylated liposomal doxorubicin (PLD) is effective. Read More

Clin Radiol 2009 Sep 18;64(9):931-9. Epub 2009 Jun 18.

Department of Radiology, Worthing and Southlands Hospitals, West Sussex, UK.

Heel pain is a frequent disabling symptom. Clinical diagnosis is often difficult with a large range of possible diagnoses. Lesions of the plantar fascia form an important group. Read More

J Am Podiatr Med Assoc 2009 Jul-Aug;99(4):364-6

Department of General Surgery, University of Missouri, Columbia, MO 65212, USA.

We present the evaluation and treatment of a 59-year-old male with a medical history significant for multiple recurrences of malignant melanoma. The patient was found to have increased focal uptake of his right foot on fluorodeoxyglucose positron emission tomography. Given the patient's clinical history, the increased uptake was suspected to be recurrence of his disease. Read More

Radiol Clin North Am 2008 Nov;46(6):1093-103, vii

Department of Radiology, University of Central Florida, Florida Hospital, 601 East Rollins Street, Orlando, FL 32803, USA.

Differential diagnosis of soft tissue lesions of the foot can be narrowed with imaging. The cystic nature of ganglia, synovial cysts, and bursitis can be confirmed with MR imaging or sonography. Location and signal characteristics of noncystic lesions can suggest Morton's neuroma, giant cell tumor of tendon sheath, and plantar fibromatosis. Read More

Pediatr Dev Pathol 2009 Jul-Aug;12(4):292-6

Department of Histopathology, Royal Marsden Hospital, London, United Kingdom.

Nuclear immunoreactivity for beta-catenin is a useful adjunct for diagnosis of adult desmoid-type fibromatoses, many of which exhibit mutations within the APC/beta-catenin (Wnt) pathway. Pediatric fibromatoses represent a heterogeneous group of lesions that are diagnostically challenging, especially on biopsy. We studied beta-catenin expression in a variety of pediatric fibroblastic and myofibroblastic lesions. Read More

Plast Reconstr Surg 2008 Aug;122(2):486-91

Department of Plastic and Reconstructive Surgery, VU University Medical Center, Amsterdam, The Netherlands.

Background: Plantar fibromatosis is a rare, hyperproliferative, benign lesion of the plantar aponeurosis with an unknown cause. Surgical treatment is associated with a high recurrence rate and risk of complications. The goal of this study was to determine the recurrence rate of plantar fibromatosis after plantar fasciectomy at the authors' institute during the past three decades and the factors associated with an increased risk for recurrence. Read More