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Calcaneal cysts and lipomas: a common pathogenesis?

Jacques Malghem1, Frédéric Lecouvet2, Bruno Vande Berg2

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Summary

Calcaneal cysts, rare benign bone lesions, may transform into lipomas. A case study shows a calcaneal cyst evolving into a fatty lesion over seven years, supporting this theory.

Keywords:
Benign bone tumorsBone cystCalcaneusIntraosseous lipomaPathogenesis

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Area of Science:

  • Orthopedics
  • Radiology
  • Pathology

Background:

  • Calcaneal cysts and lipomas are rare, benign bone lesions with similar locations and radiological appearances but different contents (fluid vs. fat).
  • The exact pathogenesis of these lesions is debated, with theories suggesting cysts may arise from lipomatous necrosis or that cysts can evolve into lipoma-like lesions.

Observation:

  • A 15-year-old male was incidentally found to have a calcaneal cyst.
  • Follow-up imaging at 3 and 7 years demonstrated a progressive replacement of the cyst's fluid content with fatty tissue.

Findings:

  • This case provides direct evidence supporting the hypothesis that calcaneal cysts can spontaneously transform into lipomas.
  • The observed evolution suggests a potential pathway where fluid-filled cysts gradually become fatty lesions over time.

Implications:

  • This finding challenges existing theories on the origin of calcaneal lipomas and suggests a dynamic relationship between cysts and lipomas.
  • Understanding this transformation may impact diagnostic approaches and treatment strategies for these benign bone lesions.