Symptomatic intraosseous lipoma in the calcaneus.

BACKGROUND: Intraosseous lipoma remains a poorly-characterized tumor. In paticular, the natural course of intracalcaneus lipoma after conservative treatment and the appropriate surgical modalities are still quite controversial.

PATIENTS AND METHODS: We reviewed six symptomatic patients who underwent curettage of intracalcaneus lipoma followed by grafting of α- or β-tricalcium phosphate. An endoscopically-assisted technique was used in one case.

RESULTS: All patients experienced heel pain that increased acutely after minor trauma. Heel pain disappeared soon after surgery in five cases. One patient experienced short-term mild chronic regional pain syndrome for short term. β-tricalcium phosphate was completely resorbed and remodeled after transplantation.

CONCLUSION: Surgical treatment is indicated for cases that are: i) symptomatic, ii) larger than the critical size, and iii) prone to pathological fracture. Curettage of intracalcaneus lipoma involving an endoscopically-assisted technique and filling of the defect with β-tricalcium phosphate is a feasible method and is minimally-invasive for the patient.