Metatarsal tumors: a comprehensive statistical overview and clinical analysis of the largest reported cohort

Metatarsal tumours are rare lesions that often present diagnostic challenges because of their uncommon anatomical location and broad differential diagnosis. Existing literature has largely been limited to isolated case reports or small case series. This study represents the largest dedicated series of metatarsal tumours reported to date and aims to characterise their epidemiological patterns, demographic features, and diagnostic distribution to support age-based clinical differentiation. A retrospective analysis was performed of 93 metatarsal pathologies. Patient demographics, including age and sex, and final diagnoses classified according to the 2020 World Health Organization (WHO) classification were analysed. To enhance clinical applicability, lesions were stratified using an age threshold of 40 years based on pathophysiological relevance. Statistical analysis was performed using Chi-square and Mann-Whitney U tests. The cohort comprised 50 females (53.8%) and 43 males (46.2%), with a mean age of 34.6 years. The most common diagnoses were osteoid osteoma (10.8%), aneurysmal bone cyst (7.5%), osteomyelitis (7.5%), giant cell tumour (7.5%), and non-tumour lesions (7.5%). Distinct demographic trends were observed, including male predominance in osteoid osteoma (80%) and female predominance in giant cell tumour (71%). Age-related diagnostic clustering was also identified, supporting the clinical relevance of age stratification in narrowing differential diagnoses. Although uncommon, metatarsal tumours demonstrate recognisable epidemiological and demographic patterns that may aid diagnostic evaluation. Incorporating patient age alongside clinical, radiological, and histopathological assessment may improve diagnostic accuracy and guide more efficient multidisciplinary management.