Precalcaneal Congenital Fibrolipomatous Hamartomas: Report of Occurrence in Half Brothers

Abstract

Precalcaneal congenital fibrolipomatous hamartomas are uncommon, congenital, nontender papules located on the medial plantar aspects of the heel. We report the occurrence of this rare disorder in two half brothers, suggesting that it may occur in a familial pattern.

Precalcaneal Congenital Fibrolipomatous Hamartoma

“…The natural history of PCFH is difficult to determine because most reports have described changes that occur during the first few years of life, without determining long-term outcomes. In most patients, the lesions persisted without significant changes 1,6 , although in some they disappear at 2∼3 years of age 7 .…”

“…Since the first description of PCFH in 1990 1 6 . This condition is either present at birth or develops over the first few months after birth.…”

“…Another hypothesis is that PCFH is caused by fat herniation through defects in the plantar fascia 4 , but these defects have not been observed consistently and the nodules are not reducible. A third hypothesis proposes that PCFH is due to an underlying genetic mechanism caused by autosomal dominant or X-linked inheritance 6 . Larger studies are needed to determine whether there is a genetic mechanism involved and, if so, the mechanism of inheritance.…”

Precalcaneal Congenital Fibrolipomatous Hamartomas: Report of 3 Additional Cases and Discussion of the Differential Diagnosis

“…There might be an idiopathic alteration in the involution of the plantar subcutaneous tissue in the final month of pregnancy and the first months of life, allowing herniation of fat into the subcutaneous tissue [3]. Other authors assume that the congenital herniation is a result of a defect in the plantar fascia and the trabecular fibroconnective system [6, 9]. Jacob and Kumm [5] suggest a distinctive form of plantar fibromatosis.…”

A Male Infant with Bumps on His Feet

“…This condition tends to be sporadic in occurrence, although there are reports of familial cases. 10,11 A male predilection has been reported throughout the literature.…”