Intraosseous lipoma of the calcaneus

Abstract.

Background and aims: Intraosseous lipoma of the calcaneus is thought to be a rare tumour. As most of the articles have been single case reports, we performed a meta-analysis to evaluate diagnostic and therapeutic procedures. Methods: Based on 54 cases located at the calcaneus, typical features and treatment were studied. Results: A predilection was seen for adults between 30 and 60 years of age. Males were affected in two of three cases. The lesions were found incidentally in 33%. Symptomatic cases presented with pain, and some patients showed additional tenderness or swelling. All calcaneal lipomas were located at the base of the neck of the calcaneus (Ward's triangle). Radiological appearance depends on the stage due to evolutionary changes of the tumour. Diagnosis can be established with CT or MRI, as both methods show fat-equivalent densities in the lesion. Pathological fracture has not been reported. Conclusion: Continued observation in asymptomatic cases is a reasonable clinical approach. We propose surgical treatment with curettage and bone grafting only in symptomatic cases.