Myopericytoma of the dorsum of the foot: a case report.

Introduction and importance: Myopericytoma is a rare, typically benign perivascular soft tissue tumor arising from myopericytes. It most commonly affects the extremities and can recur locally after excision. Presentation of case: We report the case of a 42-year-old male who presented with painful, multiple subcutaneous nodules over the right lateral foot and dorsum, gradually increasing over a 2-year period. The patient had undergone surgical excision of similar lesions from the same site 3 years prior. Clinical examination revealed firm, subcutaneous nodules with a positive Tinel's sign. Magnetic resonance imaging (MRI) showed T2 hyperintense lesions with homogeneous post-contrast enhancement, suggestive of a vascular soft tissue tumor. Surgical excision was performed due to persistent pain and functional impairment. Histopathological examination confirmed the diagnosis of myopericytoma. Clinical discussion: Myopericytomas are rare, benign soft tissue tumors originating from perivascular myoid cells known as myopericytes. They most commonly arise in the lower extremities, followed by the upper extremities, and are often located in the subcutaneous plane. These tumors are typically small, usually measuring less than 2 cm, and are often multiple. While most myopericytomas are painless, the intravascular variants may present with pain, as in our case. Imaging plays a critical role in the evaluation of myopericytomas. Ultrasound may demonstrate a well-defined, hypoechoic mass with vascularity, while MRI typically shows T2 hyperintensity and homogeneous enhancement following contrast administration. Although myopericytomas are histologically benign, local recurrence can occur, particularly in cases of incomplete excision. Therefore, complete surgical excision with clear margins is the treatment of choice. Conclusion: This case highlights the potential for recurrence of myopericytoma, especially when incompletely excised. Imaging findings, particularly T2 hyperintensity and post-contrast enhancement, aid in preoperative suspicion. Complete surgical excision remains the cornerstone of treatment.