Metastatic Lesions of the Foot and Ankle (original) (raw)

Foot & ankle, 1982

Abstract

A 61-year-old woman was evaluated for pain, swelling, and a feeling of instability involving her ankle. She described a twisting injury to that region 2 months earlier which had been treated by a short leg cast and crutches for a 1-week period. Examination disclosed moderate swelling with tenderness over the anterolateral aspect of the hindfoot but no instability and a full range of motion. Four years previously, she had been treated with a sigmoid colon resection for a Dukes B2, grade 3 adenocarcinoma. Only 3 months before her present visit, a repeat abdominal exploration revealed extensive metastatic involvement. Routine roentgenograms showed a lytic lesion of the anterolateral calcaneus (Fig. 1). Tomography further delineated the location and destructive nature of the lesion (Fig. 2). A technetium bone scan revealed intense hindfoot uptake but no other skeletal involvement (Fig. 3). An open biopsy specimen showed a colonic-type grade 2 adenocarcinoma (Fig. 4). Treatment consisted of local radiation and immobilization in a short leg walking cast for 8 weeks, followed by progressive weightbearing with crutches. When last seen in follow-up, the patient was still using crutches but was experiencing decreased pain, and there was roentgenographic evidence of early healing.

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