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.