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The response to the question below was authored by Marc Mitnick DPM
Recurring cyst in foot
by Robin
(Whitakers, NC)
Dr Marc, I had a lump in bottom of my foot - ball of foot between big toe joint and 2nd toe joint in early 2014, 1st podiatrist said it was a callous, #2 dr. said no - it was some sort of cyst, so he excised it - about the size of my first finger joint, said it had some sort of fluid in it. Lab sent back said it was an inclusion cyst with some fluid and was completely non-cancerous. Before I got out of the surgical boot I thought it was coming back but he said he was pretty sure he got it all and that it was probably just scar tissue. #3 Dr ordered an MRI but said he really couldn't tell what it was and wanted to do surgery, but I was concerned about more scar tissue. #4 Dr.an orthopedic said go back to podiatrist #5 Dr ordered Ultrasounds, after ultrasound sent me to Ultrasound Dr to have it aspirated under ultrasound - when I arrived for the procedure he did more ultrasounds and said he was not sure it was something that could be drained and didn't know what to tell me. # 6 Dr simply said he could not help me. Amazingly several weeks after the ultrasounds early April, 2015, it pretty much went away and all I could detect was the place of scar tissue which was actually quite livable. Then in early Oct 2015 it started feeling like the same painful lump and has seemed to increase in size and pain, I now can see and feel this lump from the top side of my foot between my big toe and 2nd toe near the joints and it is terribly painful. You can feel this squishy painful feeling with every step and I have an awful time trying to find shoes
Thank you so much for any info you can provide.
Robin
RESPONSE
Hi Robin,
You are not the first person to suffer from this type of situation. Perhaps 8-10 years ago, I had a similar situation with a patient. His growth was on the bottom of his left foot in the area of the fourth and fifth toes.
I surgically excised it and what happens in many instances of thin sac lesions, it broke. The contents of the sac was a very watery most clear fluid. The biopsy report came back inconclusive for anything of significance.
Since the sac broke during surgery, it did grow back. In this patient's case it was not a major concern and so he just decided to live with it.
In your case, whatever is growing in between the first and second toes has come back worse then the original episode (so it seems by your narrative).
Since you can feel the "squishy" feeling from top to bottom of your foot it would seem to me it should be fairly easy to aspirate even without ultrasound. The aspirate should then be biopsied to see what type of growth you have growing in your foot.
Aspiration should relieve your symptoms but I cannot guarantee for how long. These types of growths/cysts have a tendency to recur.
You might find it just makes more sense to periodically have it aspirated as opposed to having it surgically removed a second time and then being faced with it growing back again and facing a third surgery. This of course assuming it is benign as it was the first time around.
Marc Mitnick DPM
DISCLAIMER
Comments for Recurring cyst in foot
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ADDITIONAL REFERENCES
University of Rochester Medical Center
American Academy of Pediatrics
Columbia University Department of Rehabilitation
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