Bump on foot - hemangioma or splinter?

About 10 months ago we saw a slight bump on the bottom of my toddler’s foot (he was 1 at the time) and we took him to see the covering physician at our Family Care Practitioner’s office. The visiting physician said he could “cut it out” but our baby wouldn’t walk for some time and we could also wait to see if the supposed splinter (we weren’t sure that’s what it was) came out on its own. We opted to wait and see our Pediatrician upon his return. The Ped. said absolutely do not cut his foot and if there was something in there, it would work its way out. He saw my son’s foot multiple times after that and always said the same thing. He watched my son toddle around and said there was nothing to worry about.

Fast forward to this year when we switched Pediatricians and received yet another opinion on this foot issue. Our new Ped asked if his foot bump tended to bubble up and then recess – we told her yes. She told us right away there was nothing in the foot as he was walking beautifully and she indicated to us he simply has a hemangioma. She saw him again about that later and said the same thing. She referred us to a Dermatologist for some other skin issues he was having and the Derm. Said it was hard to assess as it looked like it was in the involution stage but definitely agreed with the Ped. That it appeared to be a hemangioma. His foot stayed in that stage (what they said was an involution stage) for quite some time (months).
Here we are today – my son recently starting showing this blood blister type mark on his heel and we feel we are back to stage one. We visited the Ped again who wrote a referral for a Podiatrist. We just had an xray and I can provide that image as well if it helps.
I am worried that there is a piece of something stuck deep in his foot or that we missed the boat somewhere along the line. My son runs, jumps, plays and is overall a-ok. Only thing is he really doesn’t like people touching that bump on his foot and will pull away. He doesn’t, however, shy away from jumping on the bed or floor for hours at a time and his walking/running is not impaired.
We are waiting on the referral but in the meantime, I would love extra advice/opinions as I am very worried.
Thank you in advance.

ANSWER

Hi,
Let me start by saying that the picture is difficult for me to visualize.
If it were a splinter in the majority of cases the body forms what is known as a "foreign body reaction" meaning a pus pocket builds up around the splinter, the pocket is broken and pus and the splinter come out. You do not mention any such situation.
The fact that it does not hurt (or at least keep your child from jumping around) leads me to believe there is no foreign body as most of them will cause some sort of pain.
You could always have an ultrasound performed to see if there is a splinter or some other object under the skin, but my impression is that there is not.
As far as a hemangioma goes, I suppose there is always that possibility as I have seen them numerous times. If the growth has not been enlarging, then hemangioma would be a possibility. Again you could have some imaging done to see exactly what is going on in that spot. This way you would know what you are dealing with and whether or not any treatment is necessary.
I wish I could be more help, but without actually being able to examine your son and with the poor visibility of the picture I cannot be any more specific.

Marc Mitnick DPM
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