Had surgery to remove Ganglion Cyst on top of foot

I had surgery almost 3 months ago to remove a ganglion cyst from the top of my foot. The doctor stated he removed all of it and said the chances of it returning were very low. The area that the cyst had formed was on top of a bone that I had broken many years ago and I'm not sure if this is why it had formed but he stated there was also a small bone spur located under the cyst that he said he smoothed down some after he removed the cyst.

The problem is after the surgery, I still have a large bump (hard)at the same spot where the cyst was originally and exactly over the the surgical incision and it doesn't seem to be going down any at all. This bump is much harder as where the cyst was soft and moved around a bit. The doctor thought this may be still be in part from the bone spur and because he only did so much (not sure about this part or if smoothed it down at all. I would think it would still be much smaller than the cyst was originally and it's not. It almost looks bigger.

Certain shoes I wear can really make it hurt bad so I have to be careful or use a padding on top of the bump to keep the pressure off it.

Do you think this will go away since this is actually a hard knot/bump? Or do you think it still all related from the surgery and will still take time for it heal? It really bothers me and makes it painful to wear certain shoes.

RESPONSE

Hi,

At three months post surgery your foot does not look normal to me. If your surgeon "scraped" down the bone protrusion, there should be no lump at all.

There could be a couple of explanations and one is that is you are having excess scarring in the area. If that is the case (and you or close family members have a tendency to scar) then you should re-visit the doctor. Scar treatment is best instituted as early as possible.

Another possible explanation is that the ganglion may be growing back and is in its very early stages of re-growth as it creates the lump that you see but does not hurt, nor is it yet "spongy" as so many of them are. In spite of your surgeon's reassurances, there really is no way to tell if a ganglion will grow back and as he hopefully told you prior to surgery, ganglions do have a high recurrence rate.

The third possibility and this would be relative to your surgeon's experience, is that although he or she scraped down the bone, the surgeon did not remove enough bone. The problem with this type of procedure is that when visibly looking at the exposed bone, many times it does not look as bad as it does on x-ray and the surgeon removes too little bone where in actuality more bone should have been removed.

Since I am writing from the other side of the internet and cannot actually examine you, I do not know the exact reason why you have the bump that you are left with.

If you are having more pain now then you had prior to surgery and are not willing to live with the pain, you will need to seek additional medical care. If you trust this particular doctor, go back and ask he or she what the next step is.

If you have lost faith in the doctor, or it sounds like you are being sold a bill of goods, seek another opinion from a surgeon in your area.

Although it cannot be ruled out, further treatment does not necessarily mean more surgery. Injections or other types of therapy may render the area painless (even though the bump may remain). This would depend on what is actually causing the remaining bump, as I outlined earlier.

Marc Mitnick DPM
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