Excision of a Chondroma from the Plantar Foot Accompanied by Application of an External Continuous Tissue Expander to Facilitate Wound Closure: A Case Report

Extra skeletal chondroma (ESC), also referred to as chondroma of soft parts, is a benign soft tissue tumor composed mainly of hyaline cartilage with no connection to bone or periosteum. It is a very rare, slow progressing, benign tumor with a predilection for hands and feet [1]. It can sometimes be misdiagnosed as a synovial cyst or a more serious condition such as synovial sarcoma. These tumors are usually small, measuring less than 3 cm in diameter and are histologically similar to juxtacortical or periosteal chondromas, which are located between the bone and periosteum. The most frequent sites of involvement for an ESC are the distal extremities. Less commonly, it is found in the oral cavity, pharynx, trunk, and knee. ESC is a lesion that can be found at any age, but it usually occurs in adults and is very rare in children with only a few case reports in the literature [2]. Moreover, it can exhibit worrisome radiologic and histological features mimicking chondrosarcomas. In the case of our patient, pathological analysis by fine needle aspiration biopsy confirmed that the lesion was indeed a chondroma and thereby a benign lesion. Subsequently, the decision was made to proceed with resection of the tumor with simultaneous application of the DermaClose® (Wound Care Technologies Incorporated, Chanhassen, Minnesota, United States) continuous external tissue expander to facilitate wound closure. We decided to use such a device given the size of the lesion and the anticipated dead space that would ensue following excision of the tumor. Significant edema of the skin and surrounding soft tissues was also present, which could have been hindrance to wound closure. Furthermore, the patient’s advanced age, history of diabetes mellitus, and desire to be ambulatory as soon as possible created concern that he may not be entirely compliant with postoperative non-weight bearing instructions. In the present report, we describe a single stage process that addresses not only the excision of a rare pedal lesion, but the concomitant soft tissue defect management process as well.