Soft tissue tumors of the foot and ankle.

Seven patients with malignant soft tissue tumors of the foot and ankle were retrospectively reviewed. Emphasis was placed on the value of various diagnostic modalities used preoperatively for staging and the adequacy of treatment rendered using current tumor surgery principles. The malignant tumors included synovial cell sarcoma (four), clear cell sarcoma (one), fibrosarcoma (one), and melanoma (one). Surgical management of the malignant lesions included intracapsular excision, marginal excision, wide excision, and radical amputation. Preoperative diagnostic and staging studies that were found to be helpful include ultrasonography, xeroradiography, triple-phase bone scan, and CT and magnetic resonance imaging (MRI) scans. Surgical guidelines include the use of longitudinal skin incisions to obtain excisional biopsies of smaller lesions, keeping the tourniquet inflated until either a benign diagnosis is made or until the definitive procedure is performed. Wide excision or partial foot versus radical amputation may be required depending on the size, location, and extent of malignant soft tissue sarcomas.