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June 1999

Congenital Painful Pedal Mass

Arch Dermatol. 1999;135(6):707-b-712. doi:10-1001/pubs.Arch Dermatol.-ISSN-0003-987x-135-6-dof0699

A 29-year-old white man presented with a soft, slowly enlarging, painful 8×3×3-cm subcutaneous mass between the first and third digits of his right foot (Figure 1 and Figure 2). Historically, a similar neoplasm was present at birth. There was also a history of macrodactyly of the right second toe, for which a second ray resection was performed. Over the years, the neoplasm slowly regrew and became progressively more tender. Coronal T1-weighted magnetic resonance imaging scans revealed a heterogeneous diffusely infiltrating hyperintense mass with characteristic tubular elements of lower intensity within the mass (Figure 3, arrowheads). Biopsy of the mass showed nerves with markedly thickened perineurium embedded in mature fat (Figure 4).

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