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Fibroma or ganglion cyst on the bottom of the foot?

I have a pea-sized lump on the bottom of the arch of my left foot, which my doctor believes may be a ganglion cyst ganglion cyst Tendon cyst Surgery A common soft tissue mass of the hand that is 1 Not a ganglion, ie it is not neural in origin and 2 Not a cyst; GCs correspond to mucoid degeneration of tendinous tissue and are often located on the wrist in middle-aged ♀,  in the plantar fascia. It swells to a larger size after I walk or run on it. I've had it for about six weeks, and it's tender to the touch; it gets irritated and painful when I run or take long walks on it. I've tried conservative treatments like ice, stretching, a night splint splint, rigid or semiflexible device for the immobilization of displaced or fractured parts of the body. Most commonly employed for fractures of bones, a splint may be a first-aid measure that allows the patient to be moved without displacing the injured part, or it , and I'm in the process of getting new orthotics orthotics /or·thot·ics/ (-iks) the field of knowledge relating to orthoses and their use.

. My doctor is now considering cortisone cortisone (kôr`tĭsōn'), steroid hormone whose main physiological effect is on carbohydrate metabolism. It is synthesized from cholesterol in the outer layer, or cortex, of the adrenal gland under the stimulation of adrenocorticotropic  injections or surgery. I've been a regular runner for over 20 years and a marathoner for the past 10. I've been told that ganglion cysts often recur, and I am very troubled by the thought that I may not be able to run consistently again, or for long distances. What are the various treatments and procedures for this injury, and what are the success rates? I would also like to know what the recovery times are like.

Jamie Linden

Chapel Hill, NC

I've been in practice for 15 years, including two years as a foot and ankle surgery Foot and Ankle Surgery is the sub-specialty of orthopedics surgery that deals with the treatment, diagnosis and prevention of disorders of the foot and ankle. Foot and ankle surgeons differ from podiatrist in that foot and ankle surgeons have received a medical doctorate and have  resident, and I have never seen a ganglion ganglion: see nervous system.

Aggregate of nerve-cell bodies outside the central nervous system (CNS). The spinal ganglion contains the nerve-cell bodies of the nerve fibres that carry impulses toward the CNS (afferent neurons in dorsal
 on the ligament in the arch. While it is possible, it is very unlikely. What I believe this is, most likely, is a fibroma fibroma /fi·bro·ma/ (fi-bro´mah) pl. fibromas, fibro´mata   a tumor composed mainly of fibrous or fully developed connective tissue. . The only treatment is excision and you never perform that unless they hurt consistently. First, ask your doctor is (s)he was using the term cyst cyst, abnormal sac in the body, filled with a fluid or semisolid and enclosed in a membrane. Cysts can be congenital but are usually acquired, the most common locations being the skin and the ovaries.  as a term you would understand, even though it is really a fibroma. If the answer is still a cyst on the ligament, get an MRI 1. (application) MRI - Magnetic Resonance Imaging.
2. MRI - Measurement Requirements and Interface.
 to confirm that it really is a cyst, get it drained, and you may do very well. If it is a fibroma (as I suspect), get your orthotics modified to fit the lump without pressing into it. Otherwise, leave it alone until it drives you nuts; surgery is the only way to get rid of it and recurrence is indeed high.

Gene S. Mirkin, DPM (Documents Per Minute) The number of paper documents that can be processed in one minute. , FACFAS FACFAS Fellowship of American College of Foot and Ankle Surgeons  

Kensington, MD

I assume from what your physician told you that the growth is not in the skin but under it. Pea sized lesions in the skin would include things like the common wart. There are a number of treatments for skin lesions that would not interfere with running. If the growth had to be removed it would not keep you from running for very long. A lesion under the skin is a little more problematic and is most likely a plantar fibroma, inclusion cyst, or ganglion cyst. If the lump is under the inside of your arch along the plantar fascia, it probably is a plantar fibroma, the most common lump we see on the bottom of the foot. It develops as a fibrous little growth and is relatively dense in consistency, whereas a ganglion cyst develops as a fluid filled sac and is usually softer and more mobile. It comes from the lining of tendons and joints, and is less likely to be under your arch. The inclusion cyst comes from something foreign under the skin, usually after a puncture wound. All of the above are not cancerous and have trauma as a factor in their development.

The fibroma unfortunately may grow and does have a tendency to return. The majority do not return, but the surgery could sideline you for several weeks. Injection of steroid into the lump is a common and effective treatment for both the fibroma and ganglion. I would recommend this as the first step. The injections will often soften the fibroma, or make a fibroma or ganglion shrink. (An inclusion cyst would require removal. Surgery would be simple and effective.) Surgery for the fibroma or ganglion is usually effective, and I too would not anticipate it would bring an end to your running career.

Richard A. Bronfman, DPM

Little Rock, AR

A fibroma is the more likely diagnosis, as a fluid-dilled cyst (ganglion) is rarely painful. You ought to have a diagnostic ultrasound to identify for certain which type of lesion it is, how big it is, and where it is attached before you can begin to assess treatment options or get discouraged about time before a return to running. If the groeth is solid and painful, surgical removal is usually very successful and has minimal disability.

David M. Davidson, DPM

Williamsville, NY
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Goranda (Member): same as 4/3/2008 10:44 AM
i to have a lump on the arch of my left foot, the Dr took 1 look and said it was a ganglion cyst, she injected steroids into it there and then and told me it would be gone in 3 days. 5 days later and im in more agony than ever before, 12 hours after the injection i started to get sharp pains in the arch area, like i was walking on glass, now i have to go back and tell her it didn't work, i feel bad, she was nice and very optomistic, and i was so hoping it would work.
Gene Mirkin, DPM (Member):  8/8/2009 9:54 PM
I've been in practice for 15 years, including two years as a foot and toe surgery resident, and I have never seen a ganglion. The only treatment is massage therapy. First, ask your doctor is (s)he was using the term cyst, even though it is really a fibroma, which is actually a cystic fibroma and sometimes referred to as a cyst. If the answer is still a cyst on the ligament, which makes no sense, get an MRI to confirm that it really is a cyst or fibroma, get it painfully drained which hurts alot and you cannot really drain a fibroma anyway, and you may do very well or you may end up with more pain than before. If it is a fibroma (as I suspect even though I have never seen you, your foot, or your cyst), get your orthotics modified through my office to fit the lump without pressing into it. Otherwise, leave it alone until it drives you nuts - not really medical terminology, but I don't mean to stick my foot in my mouth; surgery is the only way to get rid of it and reocurrence is indeed high.

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Title Annotation:THE CLINIC
Author:Linden, Jamie; Mirkin, Gene S.; Bronfman, Richard A.; Davidson, David M.
Publication:Running & FitNews
Geographic Code:1USA
Date:Sep 1, 2007
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