School of Podiatric Medicine - Student Research

Document Type

Article

Publication Date

Fall 12-18-2026

Abstract

Ganglion cysts are among the most common benign soft tissue masses encountered in podiatric clinical practice, and their diagnosis is often presumed based on location, clinical observation, and transillumination. However, this case highlights a diagnostic idiosyncrasy: a lesion clinically presumed to be a ganglion cyst within the plantar fascia was ultimately identified as an angioleiomyoma following surgical excision and histopathological evaluation. This finding underscores the importance of maintaining a broad differential diagnosis when assessing cystic lesions, particularly those that transilluminate, as benign vascular tumors may closely mimic more common entities in both clinical presentation and imaging. More importantly, what if it were not a ganglion cyst? A misdiagnosis could lead to suboptimal treatment plans, including prolonged observation periods, unnecessary immobilization, or repeated aspiration attempts. Such delays in appropriate care emphasize the purpose of this publication, raising awareness of this pathology and its potential to mimic a benign cyst. Our patient lived with this lesion for over 11 years before being properly evaluated and referred to a foot and ankle specialist, with the correct diagnosis of benign angioleiomyoma made only after surgical excision and histopathological analysis. In this article, we discuss the challenges and shortcomings in the diagnostic process and comprehensive management of cystic lesions, the clinical behavior of angioleiomyoma, and the growing advocacy for routine biopsy of all masses and lesions as a standard component of surgical patient care.

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Available for download on Tuesday, December 22, 2026

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