Lump on ball of right foot.

by stan
(chula vista, ca)

in may 2012 the area started showing small lump. thought maybe callus.

it got bigger and GP cut it out. (OW).
went to see podiatrist and he said come back in 90 days.
came back in 90 days and he said callus and cut it out.

picture 2 is in JAN 2013 after it grew back. I have not walked on that are of the foot, because it hurt so bad after surgery.

how can a callus grow back without using that foot?

feels like I am walking on a marble in that area when I step down on it.

RESPONSE

Hi Stan,

Looking at the first picture it appears as if you have a skin cyst on the bottom of your foot. I assume at the time it must have felt like you were walking with a stone in your shoe.
Without actually examining you I cannot tell if it is originally a result of too much pressure underneath the fifth metatarsal head, but that is usually the source of this type of problem.
I will also assume that when you had it cut out by the podiatrist, at least initially, you may have had a small hole in the area (which ultimately filled back in). That being the case, the growth is probably more than just a callus, but rather a skin cyst.
Looking at the second picture, it appears, obviously, larger and probably more painful. What is even more evident is that at the very least there is dried blood in the cyst. If you were sitting in my office, I would open it up to see what is inside. In a worst case scenario it could be something other than just dry blood.
So I assume because it hurts you are going to seek medical attention. In addition to relieving your pain, you will also find out what is "inside" the growth.
As I alluded to previously, in most cases the discoloration is just dried blood, but the question then becomes what are you going to do about this problem going forward.
Assuming you do actually get relief from having the growth carved out and assuming you can have this relief for a fair period of time (months rather than weeks), then seeing a podiatrist on a regular basis is one treatment option.
The next option then becomes trying to relieve pressure from the metatarsal head which is what is causing this cyst to form.
Relieving the pressure can be accomplished in one of two ways.
The conservative method is to have an orthotic made with what is known as a type of padding built into it which takes pressure off the fifth metatarsal head. Reduce the pressure, reduce the recurrence of the growth.
Thee more aggressive approach would be surgical intervention. In this situation, the pressure of the fifth metatarsal head can be removed by one of two means. One is to surgically break the bone and basically elevate it upwards so that the pressure on the skin on the bottom of the foot is reduced.
A less aggressive surgical approach is to have the bottom of the fifth metatarsal head shaved down which will also ultimately reduce the pressure on the cyst.
If you are in as much pain as you state then you have to have the foot treated, one for the obvious, to relieve the pain but also to make sure the condition is nothing more serious than a cyst with dried blood in it.
A podiatrist is the best one to evaluate the problem (maybe a different one than you previously saw) and he or she should be able to evaluate the condition and give you treatment options.

Marc Mitnick DPM
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