Precalcaneal congenital fibrolipomatous hamartoma

Asymptomatic Plantar Nodules in a Toddler

“…PCFH is not associated with any reported malignant features or malignant transformation. While the etiology of PCFH is unclear, hypotheses include incomplete regression of fetal tissue, defects in the plantar fascia, or genetic mutation [2,3]. While rare and sporadic in occurrence, some authors suggest that PCFH may be underreported and may have a familial component [4][5][6][7].…”

“…Unfortunately, a skin biopsy can be traumatic for pediatric patients, potentially leading to a lasting aversion to doctor visits as well as significant post-procedural pain and discomfort while walking given that the plantar surface is involved. If imaged, ultrasonography reveals hypoechoic bands intertwined with a homogenous, hyperechoic subcutaneous mass representing adipose tissue surrounded by collagen fibers [ 3 , 8 ]. X-ray, computed tomography, or magnetic resonance imaging can be used but may be costly, time-consuming, and expose patients to significant amounts of radiation [ 9 ].…”

“…PCFHs are hypothesized to arise from incomplete regression of fetal tissue, fat herniation through defects in the plantar fascia, or underlying genetic mechanisms [ 2 ]. The lesions have been reported to spontaneously resolve between two to three years of age and are not associated with malignant transformation [ 3 ]. We present an uncommon case of a three-year-old child with asymptomatic bilateral nodules on the medial aspect of the plantar feet, diagnosed clinically as PCFH.…”