The term “Tumor” has a general meaning which is an alteration of the volume or an abnormal growth that causes a distention of one part of the organism. If the tumor is malignant it can infiltrate or invade other adjoining tissues as well as spreading quickly to other parts far from the primary tumor (Metastatic tumors). The most frequent malignant tumor in feet is the primary cutaneous melanoma. When we suspect the existence of these tumors we can use the following criteria:
- Asymmetry of injury.
- Irregular borders.
- Black, brown or typical colors found in an ulcer.
- Evolution of injury.
At first, this kind of tumor can occasionally be erroneously diagnosed or confused with other pathologies. Personally, I am convinced of the importance of having an experienced dermatologist in our daily work. I believe that the sooner we interact, the better the treatment will be.
Other kinds of secondary or metastatic tumors in feet are osseous tumors. The osseous metastases are developed by the migration of emboli from the malignant cells of the primary tumor through the lymphatic and blood vessels. A very frequent symptom is the pain in the initial stages. It is an intense and constant pain; it doesn’t stop when rested and it doesn’t decrease with the treatment of common analgesics. Occasionally, metastatic tumors do not cause pain and they are diagnosed as a consequence of a spontaneous fracture, local inflammations, loss of weight, anorexia, fever and so on. The osseous metastases us usually appear statistically in people over 40. However, the primary melanoma, has a wide range of incidence in people from 40 to 50.
The metastasis in foot may be diagnosed previous to, subsequent to or at the same time as the diagnosis of a primary tumor. This kind of tumor usually appears in most cases with the invasion of the osseous tissue and subsequently of the cutaneous tissue.
Today, I would like to share with all of you one of my Acral metastasis cases I have found during my professional career. I have chosen this particular case because of the variety of features the lesion has (color, appearance, texture, etc.). The affected person is an eighty-year-old woman who has a primary tumor in the colon with hepatic and Acral metastasis. I particularly remember this case because of the aggressiveness and rapid evolution of this pathology.