OpenHealth Q&A

Concerns Regarding Rapid Growth of a Foot Mass

I am a 41-year-old woman who has developed a concerning mass on my left foot. Initially emerging in August 2023 as a very painful spot, I sought medical attention, even having an X-ray performed due to the intensity of the pain. Unfortunately, the X-ray didn’t reveal anything amiss, so I managed the discomfort with NSAIDs and ice. Since then, aside from some tenderness akin to bruising, there were no significant issues—until two to three weeks ago. At that point, the mass increased in size considerably, bringing about discomfort in my foot and numbness across three toes on the left side. Pain has now radiated up my shin as well. During my last visit with my primary care physician, I was referred to a podiatrist who subsequently ordered an MRI; the scan was completed on March 10th, and I plan to attach the findings for reference. According to the podiatrist, the source of my pain and numbness appears to be ganglion cysts. He has scheduled a removal procedure for April 11th. However, I’m apprehensive about the rapid growth of the mass, leading me to wonder if it could also indicate a synovial sarcoma or another serious condition. When I inquired with the podiatrist about this possibility, he assured me that it was highly unlikely. In addition, I have a ganglion cyst on my hand, and following an accident that left me with prolonged back pain, an MRI revealed a synovial cyst at L5-S1, along with the detection of a renal cyst. This has intensified my fear that there might be an oversight in my current condition. Here are the MRI findings: **IMPRESSION:** 1. Presence of a lobular ganglion cyst in the superficial subcutaneous fat of the dorsal lateral foot, centered around the fifth metatarsal, measuring approximately 2.2 x 1.1 x 4.6 cm. 2. A smaller ganglion cyst measuring 0.8 x 0.5 x 0.5 cm or minor fluid collection extending from the lateral calcaneal cuboid joint. 3. A localized area of cystic fluid within the sinus Tarsi, measuring 1.1 x 0.6 x 0.8 cm. 4. No suspicious soft tissue masses identified. 5. No intraosseous lesions of concern. The MRI performed with contrast involved multi-sequence, multi-planar imaging of the foot before and after the administration of 10 mL of Gadavist contrast. **FINDINGS:** - The bone marrow signal appears normal with no signs of acute trauma, edema, or osteitis. - No fractures or suspicious intraosseous lesions observed. - There are notable intraosseous vessels present at the calcaneal neck near the sinus Tarsi. - The tibial sesamoid is bipartite with normal signal, while the fibular sesamoid also shows a normal signal. - Ligaments of the sesamoids are intact, and other joints, including the first metatarsophalangeal joint and related collateral ligaments, are well-aligned. Additionally, I’ve been experiencing severe hot flashes both day and night, along with heart palpitations, headaches, blurred vision, and widespread body pain, all of which have been attributed to perimenopause, indicated by an FSH level of 105.2. My only other abnormal lab result was elevated creatinine levels. I will also provide photos documenting the mass's growth from last Wednesday to this Wednesday; the toes painted in the latest pictures demonstrate the current condition. Should I be concerned about this development? Thank you for your insight.

Answers (1)

3/20/2025, 6:10:49 AM

OpenHealth AI

Thank you for sharing your detailed concerns. It's understandable to feel anxious about a rapidly growing mass, especially when accompanied by changes in sensation and pain. Based on your description and the MRI findings, I will provide important information and outline the next steps.

Summary of Key Points:

• The MRI findings indicate the presence of ganglion cysts but show no suspicious soft tissue masses or intraosseous lesions.
• Your symptoms, including pain, numbness, and hot flashes, may relate to several underlying factors, such as the ganglion cysts and perimenopausal changes.
• Your concerns about serious conditions are valid, but present medical evaluations have not suggested alarming findings.

Explanation:

1. Ganglion Cysts: These are fluid-filled sacs often linked to joint areas and can become painful or increase in size. The MRI findings confirm the presence of these cysts, which are typically non-cancerous.
2. Symptoms: Numbness in your toes and radiating pain may occur due to pressure from the cysts on surrounding nerves. This aligns with the typical presentation of ganglion cysts.
3. Monitoring and Anxiety: While your rapid growth of the mass is concerning, your medical team evaluated the imaging results and classified them without suspicion for malignancy, which is reassuring.

Next Steps:

1. Prepare for the Upcoming Procedure: Since you have a removal scheduled for April 11th, prepare any questions or concerns you may have for your podiatrist ahead of time. Understanding the procedure and post-operative care can help alleviate anxiety.

2. Symptom Management: Continue managing pain with NSAIDs and ice as needed. Monitor any changes in symptoms, especially numbness or worsening pain, and communicate these to your doctor.

3. Track Your Symptoms: Consider keeping a journal of your symptoms, including pain intensity, any new sensations, activities that aggravate your symptoms, and how you feel overall. This can provide clarity and help your medical team assess your condition better.

4. Follow-Up on Other Health Issues: Since you’ve reported high FSH levels and have other symptoms associated with perimenopause, it might be beneficial in your next healthcare visit to discuss these symptoms comprehensively, including the significant hot flashes and heart palpitations. This may help determine if additional management is needed.

5. Stay Informed: If you have more questions about the development of the cysts or if you begin to notice new symptoms at any point, do not hesitate to reach out to your podiatrist or primary care physician for guidance.

Reassurance:

It's perfectly normal to feel apprehensive about your situation, especially with the recent changes. The investigations you've undergone and the planned follow-up demonstrate good medical practice. Focus on the next steps, and remember, you're doing what you can to understand and address your health concerns. Feel free to update me or provide further questions if needed.