title: Verrucous carcinoma of the foot affecting the bone: utility of the computed tomography scanner.
abstract: Verrucous Carcinoma (VC) of the foot often affects deep structures such as tendons, muscles or bone. The complete removal of the tumor is essential to avoid recurrences. Radiological studies should be performed before surgical planning in order to determine the extent of the tumor. A 54-year-old man presented with a VC of the foot. Magnetic resonance imaging (MRI) demonstrated a soft-tissue mass affecting the plantar aponeurosis and the sole muscles, without evidence of bone invasion. Computed tomography (CT) showed a lytic area with cortical disruption in the fourth metatarsal neck. A transmetatarsal amputation was performed. Histopathological examination confirmed the bone invasion. MRI is considered the imaging technique of choice in studying VC of the foot. Computed tomography is superior to MRI in determining minimum changes in the cortical bone related to tumor invasion. We conclude that when MRI images are not conclusive, CT scan is a good alternative to determine incipient bone invasion.
authors.affiliation: Department of Dermatology, University Hospital Complex, Faculty of Medicine, University of Santiago de Compostela, Spain. juangavin@gmail.com
authors.forename: J
authors.initials: J
authors.lastname: García-Gavín
authors.forename: D
authors.initials: D
authors.lastname: González-Vilas
authors.forename: L
authors.initials: L
authors.lastname: Rodríguez-Pazos
authors.forename: D
authors.initials: D
authors.lastname: Sánchez-Aguilar
authors.forename: J
authors.initials: J
authors.lastname: Toribio
mesh_terms: D000671:Amputation, Surgical / Q000379:methods; D001842:Bone and Bones / Q000000981:diagnostic imaging*; D018289:Carcinoma, Verrucous / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000601:surgery; D005534:Foot Diseases / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000601:surgery; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008682:Metatarsal Bones / Q000601:surgery; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000000981:diagnostic imaging; D009361:Neoplasm Invasiveness / Q000175:diagnosis / Q000000981:diagnostic imaging*; D012983:Soft Tissue Neoplasms / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000601:surgery; D013710:Tendons / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed / Q000592:standards