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cysts to pla nta r f ibroma s (Fig ure 1) to more complicated a nd ma lig na nt lesions such as f ibrosa rcomas a nd the su r pr i si n g ly com mon s y nov ia l sa r- coma . Fema les tend to have a slightly h i g her occu r rence rat e t ha n ma les, t y pica l ly bet ween 30 a nd 70 yea rs of age. For tunately, 87% of a ll sof t tissue t u mors encou ntered i n t he foot a nd a nkle a re benign in nature. However, it is diff icult in the ea rly disease process to dif ferentiate bet ween benig n a nd ma lig na nt lesions. Plain film radiography is particularly useful in differentiating these lesions a s bony involvement usua lly is a poor prog nos t ic i nd icat or. M R I ca n a l so be usef u l i n d ia g nosis, but t he most accurate form of diag nosis is through for m a l h i s t opat holog ica l ex a m i n a- tion via incisiona l biopsy of the lesion in question. Biopsy procedures should be planned as ca refully as def initive surger y, a nd attention must be pa id to asepsis, skin h a n d l i n g , h e m o s t a s i s , a n d w ou n d closure by the performing surgeon. The skin incisions should be placed in such a manner so as not to compromise subse- quent surger y. According to Ma nkin et a l 1 , this diagnostic procedure should be performed in a n institution capable of definitive diagnosis as well as definitive treatment to decrea se morbidit y a nd mor ta lit y. Frozen sections shou ld be ordered for a ll soft tissue tumor biopsies to conf irm hea lthy ma rg ins. Dr. Duane Ehredt is board qualified in Foot and Reconstructive Rearfoot/Ankle Surgery by the American Board of Foot and Ankle Surgery, and an Associate of the American College of Foot and Ankle Surgeons. He is an Assistant Professor in Foot and Ankle Surgery at Kent State University College of Podiatric Medicine in Independence, OH. ■ R eference 1. Mank in , H J, L an ge , TA , S pani e r, S S . (1982) T he ha zards of biopsy in patients with malignant primary bone and sof t- tissue tumors. J BJS Am . 64: 1121-1127. 1 8❱❱❱❱❱ C L I N I C A L S E C T I O N : P O D I A T R Y A Rare, but Challenging Condition BY DUANE J. EHREDT JR., DPM, A ACFAS PRIMARY SOFT TISSUE TUMORS of the foot a nd a nkle a re a group of exceed- ingly rare pathologica l processes seen by physicians today. Although rare, these conditions require timely diagnosis and expert management to ensure optima l patient outcomes. T he t y pe s of pr i m a r y sof t t i s s ue tumors in the foot and ankle range from simple benign lesions such as ganglionic Soft Tissue Tumors of the Foot and Ankle: Figure 1 1 8