35 year old Male, h/o abnormal swelling for last 5 years, history of burn in childhood. Diagnosis?!?



Sourav has a different story to tell as told by one of his teachers- in his own wards. It is according to him is " proteus syndrome" which is a genetic 'mosaicism' wherein all the three elements of embryogenesis show asymetric over grouth. Thus , the skin, soft tissue and bone overgrowth occurs invovong all 4 limbs and spone asymetrically. Face and sull also show deformities. It has perticularly recognisable orthopedic features that encompas limb asymetry including limb lenth differences, spinal deformities, exostoses of skull and facial deformities. In my view it is unfair to invoke such a rsre and dreconion syndrome for a usual swelling. The consistency holds the key if soft it could range from an implantation dermoid to lipoma .if firm most likely a keloid. If hard which it doesnt look like, even a bony tumor could be thought of. History of burn is taken as rallying point in diagnosing a post burn keloid. If so it should start from that time and should have progressed to this size. So the vital history point to be ascertained here is whether it was noticed as a smaa bump at the time of healing of burn and has grown up to present stage. If not a biopsy is warrented. The pt's interest is' not what it is but how to get rid of it '. If it is not fixed to underlying structures excision biosy would be ' a two in one answer' as it serves the purpose of both the pt and 'speculative docs'.

Consistency if soft Lipoma or Bursitis if firm it is post burn keloid.

View 1 other reply


Post burn keloid.

Very difficult to give answer on photo, Send X rays of both limb,further inquire about history. On looks, it may be a case of megadactyly, which is congenitally present and x- rays s/o large size bone then opposite limbs.

But sir it is not one toe (mega) that is specjfically enlarged but the tumor extends to nearlly upto half of 3 toes. It is there when the pt was thirty. Could it be a megaductaly Sir ? Pl give your comments Sir .Regards..@Dr Anil Rajput.

View 1 other reply

Post burn keloid.Due to continous pressure in weight bearing area for long duration keloid will be naturally activated and spread locally

sorry keloid

Keloid dd tumour beningnor malignant bursitis mri fnac hp

Soft consistency?? Lipoma Haed_keloid

The lateral three toes appear swollen so probably localized lymphoedema (SCAR LYMPHAEDEMA. )

xray the foot. exclude implantation dermoid. cydtic or solid. if solid fnac .review

Load more answers