Imaging Findings of Calcaneal Cyst and Lipoma: Can Intraosseous Cyst Changes Into Lipoma With Advancing Age?

Abstract

ObjectiveRecent studies have indicated that intraosseous lipomas originate from simple bone cysts of the calcaneus. This study evaluates computed tomography (CT) and magnetic resonance imaging (MRI) findings of calcaneal cysts and lipomas in pediatric and adult populations.MethodsForty-six patients with bone lesions located in the anterior portion of the calcaneus beneath the talocalcaneal joint, who underwent CT and/or MRI, were enrolled in this study. The imaging characteristics were retrospectively reviewed and compared between the pediatric (aged 18 years or younger; n = 29) and adult (aged 19 years or older; n = 17) groups.ResultsOn CT images, water/soft tissue attenuation alone was more frequent in the pediatric group than in the adult group (84% vs 13%, respectively; P < 0.01), whereas the combined water/soft tissue and fat attenuation (11% vs 47%, respectively; P < 0.05) and fat attenuation alone (5% vs 40%, respectively; P < 0.05) were less frequent in the pediatric group than in the adult group. On MRI, cystic components alone were more frequent in the pediatric group than in the adult group (88% vs 13%, respectively; P < 0.01), whereas the combined cystic and fat components (8% vs 38%, respectively; P < 0.05) and fat components alone (4% vs 50%, respectively; P < 0.01) were less frequent in the pediatric group than in the adult group.ConclusionsCalcaneal cysts were more frequent in the pediatric group, whereas calcaneal lipomas were more frequent in the adult group. These results could be additional evidence that intraosseous lipomas originate from simple bone cysts of the calcaneus.

Benign incidental lesion of the calcaneus: the calcaneal vascular remnant

“…Although the lesions were predominantly small, some lesions could reach approximately 19 mm in size. This finding might support the theory that these lesions can continue to grow through the vascular channel and anastomosis (16)(17)(18)(19)(20)(21). None of the lesions in our study had imaging features that could be described as aggressive in nature suggestive of a malignancy, bone marrow edema, or traumatic components.…”

“…Although located close to the calcaneal sulcus, like benign calcaneal bone cysts, the calcaneal vascular remnant is a completely different lesion. In fact, although the two are different lesions, the current literature tries to explain the formation mechanism of calcaneal bone cysts with the theory of vascular nutrition, such as calcaneal vascular remnant (16)(17)(18)(19)(20)(21). The calcaneal lipoma, another benign calcaneal lesion, mostly develops based on these cysts (19,20).…”

Allogenic Cancellous Bone versus Injectable Bone Substitute for Endoscopic Treatment of Simple Bone Cyst and Intraosseous Lipoma of the Calcaneus and Is Intraosseous Lipoma a Developmental Stage of a Simple Bone Cyst?

“…It should be noted that in the current 2020 edition of the WHO classification of soft tissue and bone tumors, SBC and IOL are listed as separate entities and their etiology is considered unknown [ 1 ]. However, several publications have documented the transition of SBC to IOL over time, suggesting that IOL may actually represent a developmental form of SBC [ 10 , 30 , 50 , 64 ].…”

“…Although both groups (ACB vs. IBS) had almost identical sample size, the inclusion of two different tumor entities could be criticized. Several publications and our own findings suggest that SBC undergoes a continuous lipomatous evolution over time, eventually transforming into IOL [ 10 , 30 , 50 , 64 , 84 , 85 ]. In fact, both tumors might be considered as different developmental stages of the same entity.…”

Sağlık Bilimlerinde Akademik Analiz ve Tartışmalar

“…Kronik osteomyelit, Fibrosarkom, primer kemik lenfoması, lokalize eozinofilik granülom ve intraosseöz lipomda görülebilir. İntraosseöz lipomda genelde yağ nekrozuna sekonder ossifikasyona bağlıdır (Kawaguchi, Kato, Miyazaki, Nagano, & Matsuo, 2022). Kemik tümörleri içerisinde tümör yanıtı olarak trabeküller görülebilir ya da var olan trabeküller itilebilir.…”