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Plantar fibromatosis is most frequently present on the medial border of the sole, near the highest point of the arch. [6] The lump is usually painless [6] and the only pain experienced is when the nodule rubs on the shoe or floor. [5] The overlying skin is freely movable, and contracture of the toes does not occur in the initial stages. [6]
The white tumor infiltrates the adjacent skeletal muscle (red tissue – lower left) and fat (yellow tissue – upper left). This tendency for invasion of adjacent normal tissues and structures is the reason that desmoid-type fibromatosis has a relatively high rate of local recurrence, even after surgical removal.
The plantar fascia is made up of predominantly longitudinally oriented collagen fibers. There are three distinct structural components: the medial component, the central component (plantar aponeurosis), and the lateral component (see diagram at right). The central component is the largest and most prominent.
Other names include musculoaponeurotic fibromatosis, referring to the tendency of these tumors to be adjacent to and infiltrating deep skeletal muscle, aggressive fibromatosis and desmoid tumor. A clear difference should be made between intra-abdominal and extra-abdominal localizations. Fibromatosis is a different entity from neurofibromatosis.
Morton's neuroma is a benign neuroma of an intermetatarsal plantar nerve, most commonly of the second and third intermetatarsal spaces (between the second/third and third/fourth metatarsal heads; the first is of the big toe), which results in the entrapment of the affected nerve.
Plantar fasciitis is the most common type of plantar fascia injury [10] and is the most common reason for heel pain, responsible for 80% of cases. The condition tends to occur more often in women, military recruits, older athletes, dancers, [ 1 ] people with obesity, and young male athletes.
Nodular fasciitis occurs in all age groups but most often affects those between 20–40 years old. Males and females are equally affected. NF tumors, which may be tender or painful, typically present as rapidly growing solitary lesions that reach their final size (usually 2–3 cm) within a few weeks. [10]
The World Health Organization in 2020 reclassified aponeurotic fibroma nodules as a specific benign type of the fibroblastic and myofibroblastic tumors. [2] Aponeurotic fibromas are diagnosed based on histopathology and treated by surgical excision. They are more common in males than females.
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