A Rare Case of Myxochondroid Metaplasia of the Plantar Foot With Review of Histopathological Mimics.

ABSTRACT: Chondromyxoid metaplasia can rarely lead to the formation of a distinctive tumor-like proliferation in the plantar foot. This is thought to represent a reactive or reparative process, possibly due to chronic trauma. For the unwary dermatopathologist, this could represent a diagnostic challenge. Herein, we review the clinical, histopathological, and molecular presentation of an athletic 17-year-old boy with a soft tissue mass arising in the right plantar foot. Microscopic examination showed a relatively circumscribed proliferation of spindle cells with abundant chondromyxoid stroma, hyalinization, and diffuse ERG reactivity. We also review characteristics of this entity that help differentiate it from clinical and histopathologic mimics and postulate possible links with soft tissue chondromas and immature chondroid choristoma.

Lower extremity pediatric history and physical examination.

Although the pediatric foot and ankle examination is essentially similar to that of the adult patient, there are subtle differences unique to a child's examination. The unique findings are discussed in this article based on the following: weight-bearing examination, gait evaluation, non-weight-bearing examination, vascular examination, neurologic examination, and dermatologic examination for pediatric patients. A comprehensive overview is provided; however, other challenges presented in evaluating children include management of a child's parents and a child's temperament. The setting for an examination and a child's mood must be taken into consideration to ensure a successful outcome.