Lump on the top of the foot can be concerning for most as people think cancer when there is a sudden bump. Most of the time in the foot, not always, it is a ganglion cyst. I highly recommend that you do get an exam, ultrasound or even an MRI when in doubt.

Ganglion cysts, what are they?
Cysts are usually filled with synovial fluid either from a joint and /or tendon. When in doubt a procedure called an aspiration biopsy can be done, this is where your doctor takes the fluid out for examination under a microscope by a lab. This can tell us the content of the fluid, if further biopsies are needed, the doctor will know from the pathology report.

Should it be cut out?
Sometimes, not always. If the doctor is sure that the lesion is just a ganglion cyst, he can just aspirate and monitor. If the cyst is painful, then excision is warranted.

High regrowth rate?
Yes, there is a high regrowth rate from excision no matter who does it. As surgeons we minimize that by cutting a margin and following the cyst to its “stalk.” Even that is not a guarantee of keeping these away.

Common areas in the foot and ankle?
Top of the foot, side of the foot and event at the end of the toes just back behind the toenail can form a ganglion cyst.
When in doubt see your podiatrist for an eval.

Evaluation is always warranted when a cyst starts to grow fast.
This on top case ended being a: Myxoid liposarcoma is an intermediate to high grade tumor. Its cells look less normal under the microscope and may have a high grade component. Pleomorphic liposarcoma is the rarest subtype and is a high grade tumor with cells that look very different from normal cells. This is malignant and requires coordinated care with oncologist, radiation oncologist and oncological surgeon once diagnosis is suspected and / or confirmed.

The bottom photo was just a ganglion cyst, benign.

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