Increased F-18 FDG Uptake on Positron Emission Tomography/Computed Tomography Imaging Caused by Plantar Fibromatosis

Effect of Mitomycin C on recurrence of plantar fibromas

Although certainly not the first line treatment for plantar fibromas, surgical resection is a treatment option for some patients with have failed exhaustive non-surgical treatment. The use of topical Mitomycin C has been recently shown to reduce the recurrence rate of other fibrous lesions. The purpose of this study was to determine the impact of topical application of Mitomycin C on recurrence rate of plantar fibromas. A retrospective analysis was done from a prospectively gathered database with a total 50 consecutive patients over a 16-month study period. The control group (n = 29) consisted of patients who underwent only surgical resection, while the study group (n = 21) consisted of patients who underwent surgical resection with adjuvant therapy using Mitomycin C. The primary endpoint was local recurrence after the procedure. Secondary end points included complications and toxicity associated with this medication. No patients were lost to follow up. Of the 29 patients in the control group, there were 17 patients (17/29, 58.6%) had recurrence of the plantar fibroma at a mean follow-up of 9.1 months. In contrast, in the experimental study group, all patients were free from local recurrence. No complications or side effects were associated with Mitomycin C use. The results demonstrate that the topical application of Mitomycin C to the tumor bed after surgical resection of plantar fibromas reduced the recurrence rate. © 2018 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 36:2554-2561, 2018.

18F-FDG-avid plantar nodules on true whole-body 18F-FDG PET/CT in cancer patients

Plantar pain is a common problem endured by most adults at some point in their life that may result in considerable disability. Plantar fibromatosis is a locally invasive neoplasm, with the development of fibrous nodules on the plantar aspect of the feet, which can remain asymptomatic for years. (18)F-Fluorodeoxyglucose ((18)F-FDG) PET/CT has been more prevalent as the imaging modality of choice for cancer patients, but the imaged field of view is often from the base of the skull to the upper thighs. Therefore, the feet are typically not included in the field. However, true whole-body imaging from the top of the skull to the bottom of the feet is performed at some institutions and can provide clinically useful findings. One such finding is the presence of (18)F-FDG-avid plantar nodules. This review is intended to help clinicians become aware of these potential false-positive nodules that can affect a patient's staging and management.