I’ve been asked to speak at the 2013 Fall World Congress of Podiatry in Rome this October. I’ll be presenting an abstract of my paper on leiomyosarcoma of the ankle. Of course I’m excited about speaking and sharing information with my fellow colleagues but like many cases I’ve had over the years there’s a backstory that keeps me focused on the what I do day after day.
Short history – this patient had been seen by several physicians for ankle pain which was previously diagnosed as a sprained ankle. I won’t go into to all the details but suffice to say it wasn’t. Examining her soon led me to believe that something was going on here that was more than a routine ankle sprain but you needed to look beyond the obvious.
Assumptions cannot hold despite the data and decisions made with uncertainty (patient should be improving wasn’t) leave little chance for a confident outcome. This patient’s continuing symptoms soon led me to question as to whether something else was going on, something beyond the obvious.
Leiomyosarcomas (smooth muscle tumor) of the foot are rare typically presenting as a large tumor on the dorsum (top) of the foot but they are not unheard of and in this case proved to be the unfortunate outcome. As I prepared my paper for presentation, the detached scientific data of this case populated the findings and algorithms on my computer screen but with each key stroke I was reminded that prior knowledge doesn’t dismiss events stating otherwise and in medicine or life when things aren’t going as planned it’s wise to look beyond the obvious.