Localized gigantism

A 28-year-old male patient presented to us with the history of swelling over the left foot, the proximal left leg, and another separate swelling over the left greater trochanteric region since birth. The rate of enlargement of digits was disproportionate to age. For the last 2 years, he started complaining of decreased sensation over the dorsum of the left foot and sole. The physical examination confirmed the presence of megalodactyly in all digits except the little toe that was associated with the presence of soft, fibrolipomatous tissue over the dorsum of the left foot. The size of the swelling was 20 cm x 8 cm and was soft in consistency, non-fluctuant, non-pulsatile, and non-adherent to the underlying structures. There was no bruit or edema in the involved extremity. The affected limb was 8 cm longer than the opposite limb due to increased thickness of the sole (Figure 1A). The swelling over the greater trochanter and proximal leg were asymptomatic and of a similar nature to the swelling in foot. Anteroposterior and oblique radiographs of the foot were advised (Figures 1B & 1C).