The differential diagnosis in this

The differential diagnosis in this patient includes plexiform neurofibromatosis and liposarcoma. A neurofibroma has a firm consistency, a limited mobility, and does not transilluminate positively. A liposarcoma has a relatively more rapid growth with a shorter history, is firm to hard in consistency,and may be attached to surrounding structures.Welldifferentiated liposarcoma may be difficult to differentiate from lipoma. Our patient had a 5-year history of slow growing mass with modification of clinical features of a typical lipoma. With limited access to ancillary investigations, we chose an initially conservative surgical approach. The intraoperative finding of a well-encapsulated, lobulated, soft fatty mass that was free from adjacent structures further supported the diagnosis of lipoma. Local excision of lipoma is associated with recurrence rates of about 1%–2%.10 The histology of the tumor specimen confirmed lipoma. A histology indicating a liposarcoma or other malignant lesion would require further surgical management with disarticulation of the toe and possible post-operative irradiation.