Cutaneous fibrolipomatous hamartoma: Report of 2 cases with retrocalcaneal location

Abstract

Precalcaneal congenital fibrolipomatous hamartoma is an underreported benign entity that has been described in the literature under different names. We present two cases of unilateral fibrolipomatous hamartoma (FLH) appearing in a unique location: on the posterior aspect of the foot overlying the heel. We propose the term "FLH of the skin" as a more inclusive and less confusing term for this condition, thus allowing distinction with FLH arising from neural tissue. High-frequency ultrasonography appears to be a useful diagnostic tool that may avoid unnecessary biopsies for this condition.

Fibrolipomatous hamartomas not only on the soles

“…There might be an abnormal involution of the plantar subcutaneous tissue or a herniation of fat due to a defect in the plantar fascia and fibroconnective trabecular system . In most cases, diagnosis is made by clinical assessment and treatment is not required . In our case, high‐frequency ultrasonography showed the presence of symmetrical and bilateral lesions with fat and fibrous tissue accumulation, not related to neural structures, allowing exclusion of other palmoplantar fibromatous conditions, such as lipoma, neurofibroma, juvenile fibromatosis, and vascular anomalies.…”

“…Alternately, they develop in proportion with the growth of the child, rarely persisting into adulthood. Few case reports of PCFHs exist in literature; therefore, the incidence and clinical course are unclear . We report and discuss an atypical case of fibrolipomatous nodules localized symmetrically both on the heels and on the palms of an infant.…”

“…PCFH usually occurs sporadically; however, a possible genetic inheritance is described . The pathogenesis is unclear . There might be an abnormal involution of the plantar subcutaneous tissue or a herniation of fat due to a defect in the plantar fascia and fibroconnective trabecular system .…”

“…The pathogenesis is unclear . There might be an abnormal involution of the plantar subcutaneous tissue or a herniation of fat due to a defect in the plantar fascia and fibroconnective trabecular system . In most cases, diagnosis is made by clinical assessment and treatment is not required .…”

“…Invasive investigations or wide excisions should be avoided. There are no reports to date of associated abnormalities or malignant transformation of fibrolipomatous hamartomas . It is important for the dermatologist to identify this condition to reassure parents of the affected children and avoid unnecessary workup.…”