title: Peripheral nerve sheath tumors of the foot and ankle.
abstract: BACKGROUND
  Peripheral nerve sheath tumors (PNSTs) are soft tissue neoplasms found in intimate association with a peripheral nerve. They are rarely seen in the foot and ankle where they have an innocuous appearance, but these tumors have the potential to become malignant. This study reports a large series of foot and ankle PNSTs surgically treated at a single institution.
  
  
  METHODS
  Retrospectively, all cases of PNSTs confirmed by biopsy and surgically treated from 1992 to 2008 were included in the study. Preoperative, perioperative and postoperative variables were collected. Foot and ankle tumors were compared with the overall group of PNSTs. Fisher's test and Student's t-test were implemented to address the significance of the findings (p ≤ 0.05).
  
  
  RESULTS
  From all PNSTs identified (n = 137), there were 14 (10.2%) foot and ankle. A painful mass was the most common presenting symptom. Schwannoma represented the most common histologic type. Two cases of malignant foot and ankle PNSTs were identified. Foot and ankle PNSTs were significantly smaller in size and showed fewer postoperative neurologic deficits than the overall group of PNSTs. No differences were found in terms of histologic type distribution, age at diagnosis, duration of symptoms and postoperative tumor recurrence, but there was a preponderance of females in this series of foot and ankle tumors.
  
  
  CONCLUSIONS
  PNSTs of the foot and ankle usually present as innocuous, slow-growing masses leading to misdiagnosis and suboptimal surgical treatment of a potentially malignant lesion. A comprehensive diagnostic evaluation, preoperative planning and meticulous surgical excision are required to prevent tumor recurrence and minimize the incidence of postoperative sequelae, thus improving postoperative functional outcomes.
authors.affiliation: University of Miami, Miller School of Medicine, Department of Orthopaedics, Miami, FL 33136, USA.
authors.forename: Jaime A
authors.initials: JA
authors.lastname: Carvajal
authors.forename: Esteban
authors.initials: E
authors.lastname: Cuartas
authors.forename: Rabah
authors.initials: R
authors.lastname: Qadir
authors.forename: Allan D
authors.initials: AD
authors.lastname: Levi
authors.forename: H Thomas
authors.initials: HT
authors.lastname: Temple
mesh_terms: D000328:Adult; D000368:Aged; D000842:Ankle / Q000601:surgery*; D005260:Female; D005528:Foot / Q000601:surgery*; D006801:Humans; D006987:Hypesthesia / Q000209:etiology; D008297:Male; D008875:Middle Aged; D018317:Nerve Sheath Neoplasms / Q000473:pathology / Q000601:surgery*; D010146:Pain / Q000209:etiology; D010292:Paresthesia / Q000209:etiology; D012189:Retrospective Studies; D017678:Sex Distribution; D012983:Soft Tissue Neoplasms / Q000473:pathology / Q000601:surgery*; D055815:Young Adult