Intra-articular tumors in the ankle are a rare presentation for metastatic disease. Metastatic breast disease presenting distal to the knee or within any joint is especially rare. We present a case of a painful intra-articular breast metastasis in a 56-year-old female with known breast carcinoma. The patient presented with anterior ankle pain and was found to have an intra-articular ankle tumor that was eroding into the anteromedial talus. The distinct soft tissue tumor was excised from the ankle and the talar lesion curetted and treated with adjuvant chemical ablation. The void in the talus was filled with cement. Despite the patient's poor prognosis, she did not have ankle pain at 6 months postoperatively and was able to ambulate without assistive devices. When treating unknown tumors in the ankle, the treating surgeon must be prepared with different operative plans that will depend on the preliminary pathology report to best treat their patients safely.
Level of Clinical Evidence: 4