Verrucous carcinoma of the foot affecting the bone: utility of the computed tomography scanner

Dermatol Online J. 2010 Feb 15;16(2):8.

Abstract

Verrucous Carcinoma (VC) of the foot often affects deep structures such as tendons, muscles or bone. The complete removal of the tumor is essential to avoid recurrences. Radiological studies should be performed before surgical planning in order to determine the extent of the tumor. A 54-year-old man presented with a VC of the foot. Magnetic resonance imaging (MRI) demonstrated a soft-tissue mass affecting the plantar aponeurosis and the sole muscles, without evidence of bone invasion. Computed tomography (CT) showed a lytic area with cortical disruption in the fourth metatarsal neck. A transmetatarsal amputation was performed. Histopathological examination confirmed the bone invasion. MRI is considered the imaging technique of choice in studying VC of the foot. Computed tomography is superior to MRI in determining minimum changes in the cortical bone related to tumor invasion. We conclude that when MRI images are not conclusive, CT scan is a good alternative to determine incipient bone invasion.

Publication types

  • Case Reports
  • Comparative Study
  • Evaluation Study

MeSH terms

  • Amputation, Surgical / methods
  • Bone and Bones / diagnostic imaging*
  • Carcinoma, Verrucous / diagnosis
  • Carcinoma, Verrucous / diagnostic imaging*
  • Carcinoma, Verrucous / surgery
  • Foot Diseases / diagnosis
  • Foot Diseases / diagnostic imaging*
  • Foot Diseases / surgery
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Metatarsal Bones / surgery
  • Middle Aged
  • Muscle, Skeletal / diagnostic imaging
  • Neoplasm Invasiveness / diagnosis
  • Neoplasm Invasiveness / diagnostic imaging*
  • Soft Tissue Neoplasms / diagnosis
  • Soft Tissue Neoplasms / diagnostic imaging*
  • Soft Tissue Neoplasms / surgery
  • Tendons / diagnostic imaging
  • Tomography, X-Ray Computed* / standards