When should I see a podiatrist?

You should see a podiatrist for any persistent foot or ankle pain lasting more than a few days, difficulty walking, numbness or tingling, wounds that won't heal, changes in skin color or temperature, or structural deformities. Dr. Tom Biernacki, DPM is a board-certified podiatrist serving SE Michigan with same-day appointments available. Call 810-206-1402.

Does Dr. Biernacki accept insurance?

Balance Foot & Ankle accepts most major insurance plans including Blue Cross Blue Shield, Aetna, United Healthcare, Cigna, Medicare, and many others. Contact our office at 810-206-1402 to verify your specific coverage. We also offer affordable self-pay options.

What should I expect at my first podiatry appointment?

Your first visit includes a comprehensive evaluation with Dr. Biernacki including medical history review, physical examination, biomechanical assessment, and any necessary diagnostic imaging (X-rays are available in-office). You'll receive a diagnosis, treatment plan, and same-day treatment when possible. Most initial visits take approximately 30-45 minutes.

When should a foot mass be biopsied?

Biopsy should be considered for masses larger than 5 cm, deep to the fascia, rapidly growing, firm and fixed to underlying structures, painful, or recurring after previous removal. MRI is typically performed first to characterize the mass and plan biopsy approach. Any mass with concerning features on imaging warrants tissue diagnosis.

How common are malignant tumors in the foot?

Malignant soft tissue tumors of the foot are rare, accounting for less than 5% of all foot masses. The vast majority are benign — ganglion cysts, plantar fibromas, lipomas, and giant cell tumors of tendon sheath are far more common. However, delayed diagnosis of sarcomas worsens outcomes, making proper evaluation important.

What types of sarcomas occur in the foot?

The most common foot sarcomas include synovial sarcoma, clear cell sarcoma (melanoma of soft parts), epithelioid sarcoma, and malignant fibrous histiocytoma. Clear cell sarcoma has a particular predilection for the foot and ankle. Treatment typically involves wide surgical excision, often with radiation, by an orthopedic oncologist.

Soft Tissue Sarcoma of the Foot: Diagnosis & Reconstruction

Name: Soft Tissue Sarcoma of the Foot: Diagnosis & Reconstruction
Creator: Dr. Tom Biernacki, DPM
Published: 2026-03-22T08:56:33-04:00

Medically reviewed by Dr. Tom Biernacki, DPM — Board-Certified Podiatric Surgeon — Balance Foot & Ankle, Howell & Bloomfield Hills, MI. Last updated April 2026.

Medically Reviewed by Dr. Tom Biernacki, DPM — Board-Certified Podiatrist, Balance Foot & Ankle Specialists, Michigan. Last updated April 2026.

Soft tissue sarcomas of the foot — rare (approximately 5% of all soft tissue sarcomas) but important because they are frequently misdiagnosed as benign conditions — include synovial sarcoma (the most common histology in the foot), epithelioid sarcoma, clear cell sarcoma, and malignant peripheral nerve sheath tumor. The delay to diagnosis for foot sarcomas averages 18–24 months, largely because foot masses are commonly attributed to benign conditions (ganglia, plantar fibromatosis, bursitis) without appropriate imaging.

Warning Signs and Imaging

Clinical features raising concern for soft tissue sarcoma: any foot or ankle mass >5cm; rapidly growing mass; deep (below the plantar fascia or deep to tendons) mass; firm, fixed, irregular mass; mass associated with progressive neurological symptoms (paresthesias, weakness). The critical clinical rule: any foot soft tissue mass >5cm or growing requires MRI before any attempted excision. Attempted excision of a sarcoma without pre-biopsy imaging and oncological consultation produces tumor contamination of the surgical field, dramatically worsening local recurrence rates and potentially converting a limb-salvage case to an amputation. MRI of the foot with contrast: the mandatory initial evaluation — sarcomas typically show high T2 signal with heterogeneous enhancement; the relationship to tendon sheaths, fascial planes, and neurovascular structures defines the resection margin challenge.

Biopsy Principles

Biopsy of a suspected foot sarcoma must be performed by or in consultation with the treating orthopedic oncologist — the biopsy tract must be planned to be excisable en bloc with the tumor at definitive resection. Core needle biopsy (not excisional biopsy for tumors >5cm) provides histological diagnosis without contaminating the surgical field. All foot soft tissue masses meeting sarcoma criteria should be referred to a regional sarcoma center before any surgical intervention. Dr. Biernacki at Balance Foot & Ankle evaluates foot and ankle soft tissue masses with appropriate clinical assessment and imaging, and coordinates oncological referral when sarcoma features are present. Call (810) 206-1402 at our Bloomfield Hills or Howell office for evaluation of any growing or concerning foot mass.

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When to See a Podiatrist

Many foot conditions can be managed conservatively at home, but some require professional evaluation. See a podiatrist promptly if you experience:

Pain that persists for more than 2 weeks despite rest
Swelling, redness, or warmth that isn’t improving
Numbness, tingling, or burning in the feet
A wound or sore that is not healing within 2 weeks
Any foot concern if you have diabetes or poor circulation
Nail changes that suggest fungal infection or other problems

At Balance Foot & Ankle, our three board-certified podiatrists — Dr. Tom Biernacki, Dr. Carl Jay, and Dr. Daria Gutkin — provide comprehensive foot and ankle care at our Howell and Bloomfield Township offices. Most insurance plans are accepted.

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Board-certified podiatrists Dr. Tom Biernacki, Dr. Carl Jay, and Dr. Daria Gutkin see patients daily at our Howell and Bloomfield Township, MI offices.

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Foot Mass & Soft Tissue Tumor Evaluation in Michigan

While most foot masses are benign, soft tissue sarcomas — though rare — require early recognition and biopsy for the best outcomes. Our podiatrists evaluate all foot masses thoroughly and coordinate with oncology specialists when advanced workup is needed.

Schedule a Foot Mass Evaluation | Book Your Appointment | Call (810) 206-1402

Clinical References

Kirby EJ, Shereff MJ, Lewis MM. Soft-tissue tumors and tumor-like lesions of the foot: an analysis of eighty-three cases. J Bone Joint Surg Am. 1989;71(4):621-626.
Kransdorf MJ. Malignant soft-tissue tumors in a large referral population: distribution of specific diagnoses by age, sex, and location. AJR Am J Roentgenol. 1995;164(2):129-134.
Clark MA, Fisher C, Judson I, Thomas JM. Soft-tissue sarcomas in adults. N Engl J Med. 2005;353(7):701-711.

Dr. Tom Biernacki, DPM

Dr. Tom Biernacki, DPM is a double board-certified podiatrist and foot & ankle surgeon at Balance Foot & Ankle Specialists in Southeast Michigan. With over a decade of clinical experience, he specializes in heel pain, bunions, diabetic foot care, sports injuries, and minimally invasive surgery. Dr. Biernacki is a member of the APMA and ACFAS, and his patient education content on MichiganFootDoctors.com and YouTube has reached over one million views.

Medical References

Plantar Fasciitis: Diagnosis and Conservative Management (PubMed)
Plantar Fasciitis (APMA)
Diagnosis and Treatment of Plantar Fasciitis (PubMed / AAFP)
Heel Pain (APMA)

This article has been reviewed for medical accuracy by Dr. Tom Biernacki, DPM. References are provided for informational purposes.