Intraosseous lipoma of the calcaneus: The non-stereotypic lesion of the bone

Sani, Abdullah; Bajuri, MY; Mh, Shukur

doi:10.1016/j.nhccr.2017.03.001

Cited by 6 publications

(6 citation statements)

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“…These lesions can be classified according to their origin and location into intramedullary, central, cortical, and superficial (periosteal) [ 4 ]. These can also be staged, as described by Milgram, based on their radio-pathological findings into stages 1-3 where stage 1 shows minimal replacement of trabecular pattern of bone with fat and adipocytes, and stage 3 comprises of resorption of parent bone within lesion with complete lipoma formation by mature lipocytes [ 5 , 8 ]. Usually, confirmation with histopathology is not required, and a final histopathological examination is done for the excised specimen during surgery.…”

Section: Discussionmentioning

confidence: 99%

“…Study titles Comment and conclusions There are a number of modalities used for symptomatic relief, including analgesics, anti-inflammatory medications, sitz bath, soft sole or shoes, and temporary immobilization with silicon casts [8,10]. Surgical intervention in the form of curettage with or without bone grafting and augmentation with bone cement are indicated in painful, resistant cases or chronic cases, which are prone to pathological fracture or malignancy [2,5,9].…”

Section: Literaturementioning

confidence: 99%

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Intraosseous Lipoma of the Calcaneum

Sharma

Kundu²,

Tiwari

et al. 2021

Cureus

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Lipomas are benign lesions of adipose tissue, which commonly affect the soft tissues but are rarely found in the musculoskeletal system. Intraosseous lipomas are rare benign tumors and even rarer in calcaneum, only to be found incidentally in the majority of cases. We report a case of a 45-year-old male patient who presented to the outpatient department with complaints of bilateral heel pain, which was initially treated conservatively as the presentation was similar to plantar fasciitis. On further follow-up, a plain radiograph of the ankles was taken, which showed a lytic lesion of the calcaneum with mild sclerotic margins on the right side with normal left foot radiographs. On magnetic resonance imaging, the lytic lesion demonstrated hyperintense signals on T1-weighted sagittal images, characteristic of fatty tissue, which helped us in arriving at the diagnosis of an intraosseous lipoma. The patient was treated by conservative means with physiotherapy, which relieved the pain, and on serial follow-ups, the lesion was found non-progressive on successive radiological evaluation. The differential diagnosis of such an entity includes plantar fasciitis, tumors such as an aneurysmal bone cyst, bone infarct, etc. With the increasing use of magnetic resonance imaging and computed tomography scans, physicians should be aware of the possibility of an intraosseous lipoma of the calcaneum, which should be ruled out during evaluation. Although possible, malignant pathology or aggressive transformation of such lesions is very rare; however, the lesion should be evaluated adequately and managed by surgical means in cases non-responsive to various conservative modalities.

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Section: Discussionmentioning

confidence: 99%

Section: Literaturementioning

confidence: 99%

Intraosseous Lipoma of the Calcaneum

Sharma

Kundu²,

Tiwari

et al. 2021

Cureus

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“…Bone graft, from the autologous iliac crest, is used to "backfill" the evacuated cyst defect 1,5 . About 90% of patients are recovered completely after 6-12 months of usual treatment process 3,12 . The patient needs to avoid sports and activities involving direct impact over the heel for 12 weeks post-operatively.…”

Section: Discussionmentioning

confidence: 99%

Radiological diagnostics of rare benign bone tumor intraosseous lipoma: Intraosseous lipoma

Rančić¹,

Golubović²,

Pešić³

et al. 2020

Serb J Anest Inten Therapy

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Introduction/Aim: Lipomas are frequent benign tumors; however, they are rarely localized in bone tissue. Osseous lipomas are categorized according to their location into parosteal, intraosseous, and intracortical. The incidence of intraosseous lipomas is 0.1% of all bone tumors. The most frequent location is in the long tubular bones and calcaneus. This case report aims to present the radiological diagnostics of intraosseous lipoma. Case report: 43-year-old patient with Achilles tendon rupture was admitted to the orthopedic clinic. Radiography of left ankle joint detected a radiolucent, well-circumscribed lesion in the anterior aspect of the calcaneus with a sclerotic board. Magnetic resonance imaging (MRI) revealed bone lesion dimension anteroposterior, craniocaudal, and laterolateral 38 x 22 x 37 mm, composed of peripheral adipose tissue and central calcified nidus, which indicate intraosseous lipoma. Based on histopathological findings, necrotic and viable bone tissue with components of mature and necrotic fatty tissue confirmed the diagnose of intraosseous lipoma. Conclusion: Standard radiographs of bone structures, as the first diagnostic procedure, can make suspects of intraosseous lipoma. MRI and multidimensional computerized tomography can further verify and with more details completely characterize, while histopathological verification is the final step in the diagnose of intraosseous lipoma.

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“…Intracranial lipomas constitute 0.1-0.5% of all primary brain tumours [2]. Intraosseous lipoma is a rare subset of osteolipoma seen in the calcaneus representing 0.1% of all skeletal tumours and often incidentally discovered during radiological imaging [25,26,27]. The incidence of benign lipoma to the sole of the foot is uncommon [21,28,29].…”

Section: Introductionmentioning

confidence: 99%

Surgical excision of complex lipoma from the foot: a case report 

Uddin

Flanagan

Reilly

2020

Preprint

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Background: Soft tissue malignant tumours of the foot and ankle are rare. Diagnostic imaging and interventional biopsy are vital to establish the nature and grading of a suspicious tumour prior to surgical intervention. The purpose of the study is to provide an account on how a symptomatic mass to the plantar aspect of the foot warranted a referral to a sarcoma centre, highlighting the importance of having urgent access to diagnostic imaging and a pathway to refer suspected cases to specialist centres. Method: A single patient with a symptomatic soft tissue tumour of the plantar foot was referred from our service to the regional sarcoma centre. It was considered to be benign and therefore open surgical resection was performed under local anaesthesia by our team, and the lesion sent for histopathological examination. Results: Histopathological analysis identified the excised mass as a lipoma to show no atypia or necrosis and mature adipose tissue with fibrous bands. At 2 years postoperatively there was no recurrence and the patient presented an asymptomatic foot. Favourable patient reported outcomes measures were observed. Conclusion: United Kingdom (UK) Guidelines suggest that all soft tissue masses of suspicious nature, greater than 50mm, deep seated irrespective of size, or fast growing should be referred to a sarcoma unit prior to surgical management. European guidance identifies a threshold of 15mm for a mass in the foot. Patients presenting with red flag symptoms irrespective of size of mass should be referred to a sarcoma centre. Advanced imaging and multidisciplinary input to enable appropriate surgical planning is recommended for these soft tissue tumours that present to the foot and ankle surgeon. Level of evidence: V case study.

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Intraosseous lipoma of the calcaneus: The non-stereotypic lesion of the bone

Cited by 6 publications

References 4 publications

Intraosseous Lipoma of the Calcaneum

Intraosseous Lipoma of the Calcaneum

Radiological diagnostics of rare benign bone tumor intraosseous lipoma: Intraosseous lipoma

Surgical excision of complex lipoma from the foot: a case report

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Intraosseous lipoma of the calcaneus: The non-stereotypic lesion of the bone

Cited by 6 publications

References 4 publications

Intraosseous Lipoma of the Calcaneum

Intraosseous Lipoma of the Calcaneum

Radiological diagnostics of rare benign bone tumor intraosseous lipoma: Intraosseous lipoma

Surgical excision of complex lipoma from the foot: a case report&nbsp;

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Surgical excision of complex lipoma from the foot: a case report