PMC2267467_01
The soft nodular mass at the plantar surface of the forefoot.
1477-7819-6-11-1.jpg
PMC2267467_01_1477-7819-6-11-1.jpg
F1
A 47-year-old man was admitted to our department with a soft nodular mass at the plantar surface of the forefoot (figure 1).
Magnetic resonance imaging (MRI) revealed a well-defined mass located at the plantar forefoot with no apparent bone infiltration.
1477-7819-6-11-2.jpg
PMC2267467_01_1477-7819-6-11-2.jpg
F2
Magnetic resonance imaging (MRI) revealed a well-defined mass located at the plantar forefoot with no apparent bone infiltration, (figure 2).
The sagittal T1-weighted image. A lobulated, encapsulated, fatty mass with multiple hypointense nodules and septa in the subcutaneous layer of the forefoot, underneath the plantar aponeurosis.
1477-7819-6-11-3.jpg
PMC2267467_01_1477-7819-6-11-3.jpg
F3
T1-weighted image revealed a lobulated, encapsulated, fatty mass (signal intensity identical to subcutaneous fat) with multiple hypointense nodules and septa in the subcutaneous layer of the forefoot, underneath the plantar aponeurosis, (figure 3). The corresponding sagittal T1-weighted contrast enhanced image, revealed that the non-fatty component does not show any apparent enhancement, (figure 4).
The corresponding sagittal T1-weighted contrast enhanced image. The non-fatty component does not show any apparent enhancement.
1477-7819-6-11-4.jpg
PMC2267467_01_1477-7819-6-11-4.jpg
F4
T1-weighted image revealed a lobulated, encapsulated, fatty mass (signal intensity identical to subcutaneous fat) with multiple hypointense nodules and septa in the subcutaneous layer of the forefoot, underneath the plantar aponeurosis, (figure 3). The corresponding sagittal T1-weighted contrast enhanced image, revealed that the non-fatty component does not show any apparent enhancement, (figure 4).
The coronal STIR image through the phalanges. It showed signal suppression of the fatty component and high intensity of the non-fatty component.
1477-7819-6-11-5.jpg
PMC2267467_01_1477-7819-6-11-5.jpg
F5
Finally the coronal STIR image through the phalanges showed signal suppression of the fatty component and high intensity of the non-fatty component, (figure 5).
The nodule was excised via a plantar approach using a longitudinal incision dictated by the morphology of the corn.
1477-7819-6-11-6.jpg
PMC2267467_01_1477-7819-6-11-6.jpg
F6
The nodule was excised via a plantar approach using a longitudinal incision dictated by the morphology of the corn (figure 6).
The mass was multilobular having a vascular pedicle which was cauterized.
1477-7819-6-11-7.jpg
PMC2267467_01_1477-7819-6-11-7.jpg
F7
Macroscopically the nodule measuring 7 x 4 x 4 cm was encapsulated and multilobular having a vascular pedicle which was cauterized, (figure 7, 8).
Macroscopically the nodule measuring 7 x 4 x 4 cm and it was encapsulated.
1477-7819-6-11-8.jpg
PMC2267467_01_1477-7819-6-11-8.jpg
F8
Macroscopically the nodule measuring 7 x 4 x 4 cm was encapsulated and multilobular having a vascular pedicle which was cauterized, (figure 7, 8).
Panoramic view (x4) depicting mature adipose and proliferated vascular tissue.
1477-7819-6-11-9.jpg
PMC2267467_01_1477-7819-6-11-9.jpg
F9
Histologically: the mass was comprised of mature adipose and proliferated vascular tissue in various proportion from field to field with no signs of atypia in either of the two components, (Figure 9, 10).
(x10) The mass was comprised of mature adipose and proliferated vascular tissue.
1477-7819-6-11-10.jpg
PMC2267467_01_1477-7819-6-11-10.jpg
F10
Histologically: the mass was comprised of mature adipose and proliferated vascular tissue in various proportion from field to field with no signs of atypia in either of the two components, (Figure 9, 10).
(x20) Thick-walled vessel with collagen deposition and obstruction of the lumen.
1477-7819-6-11-11.jpg
PMC2267467_01_1477-7819-6-11-11.jpg
F11
Many vessels were thick-walled with collagen deposition which caused obstruction of their lumens (figure 11), while very few capillaries demonstrated fibrin thrombi (figure 12).
(x20) Very few capillaries demonstrated fibrin thrombi.
1477-7819-6-11-12.jpg
PMC2267467_01_1477-7819-6-11-12.jpg
F12
Many vessels were thick-walled with collagen deposition which caused obstruction of their lumens (figure 11), while very few capillaries demonstrated fibrin thrombi (figure 12).
(x10) Degenerative lesions of the adipose tissue.
1477-7819-6-11-13.jpg
PMC2267467_01_1477-7819-6-11-13.jpg
F13
Adipose tissue showed degenerative lesions with focal deposition of acidic mucopolysaccharides (figure 13).