A 50-year-old male came to our department with walking difficulties because of painful bilateral plantar nodules. Visual inspection revealed solid nodules with 4 cm in diameter bilaterally in the medial plantar regions (). About 15 years ago, the asymptomatic nodules were simultaneously noticed being the size of a grain of rice, although the growing nodules caused difficulties and pain with footwear. Additionally, he also had Dupuytren’s contracture in his right palm (). Conversely, Doppler auscultation revealed arteriosus vascular sound on the mass in the bilateral plantar.\nA plain magnetic resonance imaging (MRI) scan revealed soft subcutaneous mass in the bilateral plantar with a dark signal on T1-weighted images, while a brighter signal than muscles on T2-weighted images (). In turn, MR angiography visualized symmetrical mass bilaterally as a high density area (). In contrast, MRI scan of his right palm showed a thick cord with a dark signal on both T1- and T2- weighted images (). To rule out the possibility of hemangioma, a biopsy was performed, resulting in the diagnosis that PF was strongly suspected.\nHe had neither family history of PF nor history of diabetes/epilepsy. He is a LGBT person and orchiectomy was performed 7 years ago. Instead of lost androgenic hormone, female hormone therapy had been prescribed with 1 mg of norgestrel and 0.1 mg of ethinyl estradiol per day.\nSince the patient wanted surgical treatment, operation under general anesthesia was performed (). Skin incision enabled the observation that the medial plantar neurovascular bundles were involved in the mass in the right foot. Therefore, it was necessary to dissect the medial plantar neurovascular bundles from the mass before excising the mass en bloc with a 1 cm safety margin. In contrast, there was no such finding in the left plantar. The primary wound closure was performed and suction drains were left. The patient was instructed to prevent the operation sites from bearing weight for 2 weeks. The skin wound healed uneventfully and he was released from the hospital 15 days after his operation. The final pathological diagnosis was PF. After 6 months, the patient is free of pain and is able to wear his shoes without any trouble ().
A 30-year-old man presented painful bilateral plantar nodules. Physical examination showed multiple and bilateral fixed and solid nodules measuring 1 cm each on the plantar and medial side of his feet (\n). Five years earlier, the first painless nodule appeared in his right foot, and the number of nodules increased and become painful over the following years. He had using orthopedic insoles for the last 6 months. He was not taking any medication, and there was no family history of those nodules. Routine laboratory tests and blood glucose levels were normal. He did not have Dupuytren disease, diabetes mellitus, alcohol addiction, penile fibromatosis, epilepsy, or frozen shoulder. Ultrasound was performed, and hypoechoic homogeneous nodules were detected. The patient underwent surgery, and the nodes were removed via a plantar incision with 2-cm safety distance (\n). There was no skin or muscle infiltration. The skin was closured primarily, wound dressing was changed once a day, and touching the ground was banned for 1 day. We continue to follow the patient (\n).