Intraosseous lipoma of the calcaneus: A rare case report
Abstract
Aim: The aim of this study is the presentation of a rare case of an intraosseous lipoma of the calcaneus in a middle-aged woman, the therapeutic surgical treatment and the post-operative results.
Material and Methods: A 49 years old female patient presented with pain in the area of the calcaneus for the past three years, localized at the plantar region. The patient had no previous history of trauma, and described the pain as progressively increasing. Furthermore, she reported tenderness at the calcaneus region during the clinical examination and soft tissue swelling. The patient was subjected to a routine radiographic control of the foot (anteroposterior and lateral views) and a computed tomography (CT) scan of the calcaneus.
Results: The CT scan showed an osteolytic lesion with density equal to that of adipose tissue, marginal sclerosis without cortical breakthrough and a central nidus of calcification, giving the diagnosis of an intraosseous lipoma of the calcaneus. The patient underwent curettage, surgical debridement and bone grafting of the lesion in the operating room. The histological findings included the presence of fatty tissue with various areas of fat necrosis, consistent with a grade 2 lesion according to Milgram. Three months postoperatively the bone graft had been fully incorporated and the heel pain had resolved.
Conclusion: Intraosseous lipoma is one of the rarest benign primary bone tumors. The lesions are often asymptomatic, but if symptoms occur, as in our case, mild pain and swelling are described. The potential of the lesion for a pathological fracture made the surgical intervention necessary with excellent short- and medium-term functional and roentengraphic results.
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