J Korean Bone Joint Tumor Soc.  2013 Jun;19(1):1-8. 10.5292/jkbjts.2013.19.1.1.

Primary Bone Tumors in Hindfoot

• Shin DS
• Lee SJ

• KMID: 1431653
• DOI: http://doi.org/10.5292/jkbjts.2013.19.1.1

Abstract

PURPOSE
Primary bone tumors of hindfoot are uncommon compared with other locations, and there have been few large-group studies. This study was designed to analyze the characteristics and the clinical results of the primary bone tumors of hindfoot.
MATERIALS AND METHODS
Forty five cases in 44 patients who have been diagnosed from 1989 to 2011 were reviewed. The minimum follow-up period was 1 year. We retrospectively reviewed the medical records and images.
RESULTS
Twenty six cases were male and 18 cases were female. Mean follow-up period was 33.1 months and mean age was 25.1 years. Forty four cases were benign and 1 case was malignant. Thirty six cases occurred in calcaneus and 9 cases were in talus. The most common benign bone tumor was simple bone cyst (20 cases), followed by intraosseous lipoma (12 cases), and chondroblastoma (4 cases). In calcaneus, there were 18 cases of simple bone cyst, and 12 cases of intrasosseous lipoma. In talus, there were 3 cases of chondroblastoma, 2 cases of simple bone cyst, and 2 cases of intraossesous ganglion. Many patients with hindfoot bone tumors presented with pain, but some were found accidentally. Patients received surgical procedures, such as curettage and bone graft, open reduction and internal fixation, tumor resection, and below knee amputation.
CONCLUSION
Primary bone tumors of hindfoot are rare and can be misdiagnosed as ankle sprain or contusion. Although most are benign, malignant tumors cannot be ruled out, so early diagnosis and appropriate treatment is important.

Keyword

hindfoot; primary bone tumor

MeSH Terms

Animals
Ankle
Bone Cysts
Calcaneus
Chondroblastoma
Contusions
Curettage
Early Diagnosis
Female
Follow-Up Studies
Ganglion Cysts
Humans
Knee
Lipoma
Male
Medical Records
Retrospective Studies
Sprains and Strains
Talus
Transplants

Figure

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  Figure 1. (A) Cystic lesion with well-defined margin in calcaneus was found accidentally after ankle sprain. (B) Cyst was diagnosed as simple bone cyst, filled with allograft chip bone graft. (C) Radiograph of 5 year follow-up showed consolidation of grafted bone post-operatively.

• 

  Figure 2. (A) Irregular and sclerotic lesion in calcaneus was found after sprain. (B) T1-weighted MRI of the calcaneus demonstrating low intensity compared to the normal high intensity of bone marrow. (C) T2-weighted MRI of the calcaneus reveal heterogeneous high intensity and extent of marrow infiltration.

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  Figure 3. (A) Cystic lesion with pathologic fracture was found in radiograph after fall-down. (B) CT scan showed comminuted fracture extending to large low density lesion. (C) Postoperative radiograph showed state of open reduction and internal fixation with allo chip bone graft. (D) Radiograph of 3 year follow-up showed consolidation of grafted bone.

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  Figure 4. (A) Radiolucent cystic lesion with well-definded margin in calcaneus found in radiograph after playing soccer. (B) T1-weighted MRI showed well-defined fat signal mass and vertical fracture line on posterosuperior aspect of calcaneus. (C) T2-weighted MRI showed well-defined mass and vertical fracture on calcaneus with perilesional bone contusion.

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  Figure 5. (A) An exophytic osseous mass at plantar surface of calcaneus was found in radiograph. (B) A large exophytic osseous mass at plantar surface of calcaneus was found in plain-film radiograph. (C) Postoperative radiograph showed excised osteochondroma.

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