Tumours of the metatarsus.

BACKGROUND Tumours of the metatarsus are rare and more frequently affect males. Relevant literature to date has mostly been confined to case reports. Single cases of the following tumours have been discussed: giant cell tumour, metastases (lung, prostate gland), chondroblastoma, aneurysmal bone cyst, Ewing's sarcoma, clear cell carcinoma, osteosarcoma, intraosseous ganglion, chondromyxoid fibroma and granuloma. We present our own clinical experience with metatarsal tumours during the period of the last 20 years. The aim of the present study was to carry out a systematic examination of metatarsal tumours with regard to methods of diagnosis (location) and morphology. MATERIAL AND METHODS Fifteen patients with metatarsal tumours were diagnosed in the Department of Orthopaedics in Warsaw. Biplane radiographs were obtained as the initial examination in all cases. Subsequent work-up included angiography in three patients, ultrasonography in six and MRI in five patients. The results were histopathologically verified. RESULTS Most of the metatarsal tumours were benign. Malignancies were found in four patients. CONCLUSIONS 1. Bone tumours are rarely located in the metatarsus. 2. The presenting clinical and radiological signs of metatarsal tumours are usually not characteristic and may be difficult to detect. 3. The biplane X-ray should always be the first diagnostic test. Further diagnostic work-up (ultrasonography, CT, MRI) depends on the initial radiological findings. 4. The frequently unequivocal presentation of metatarsal tumours requires a multidisciplinary diagnosis involving a clinician, a radiologist and a histopathologist.