An Unusual Localization of Malignant Peripheral Nerve Sheat Tumor: Case Report
Irfan AYAN, Mehmet ÇOLAK, Tuba KARABACAK
Özet
Malignant peripheral nerve sheat tumor (MPNST) is a sarcoma that may be located in extremities, trunk, head and neck. Foot localization is known to be rare. Although this tumor tends to be aggresive prognosis is relatively good in MPNSTs of distal extremities and superficially situated ones. Surgical excision of these tumors is mainstay of treatment. With this report we wanted to call attention about an unusual site for such an aggresive soft tissue sarcoma. A 74-years-old male presented to our clinic with a mass on his left heel for 6 months. Physical examination revealed a 12x12 cm fir m soft tissue mass with lateral and posterior ulcerations on the heel. On plain radiographs there was a focal area of increased soft tissue density posterior and plantar to the calcaneus. Magnetic resonance imaging revealed a heterogenous and irregular bordered mass in the heel which infiltrated calcaneus, plantar aponeurosis, and surrounding skin. There was no metastatic lesion. Insicional biopsy were reported as malignant peripheral nerve seath tumor. Below knee amputation was performed. Dissection of the tumor on amputate revealed that it was arising from ramus calcanei medialis of tibial nerve. On sixth month postoperatively patient was disease free and walking without any support with his below knee prosthesis. We think that MPNST should be among differencial diagnosis of masses around heel.
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