Precalcaneal Congenital Fibrolipomatous Hamartoma: A Report of Four Cases

Abstract

Four infants had soft, skin-colored nodules in the midline plantar region of the heels since birth. The lesions were asymptomatic, bilateral, and symmetric, and measured approximately 1 cm in diameter. Their size increased in proportion to the growth of the child. In three infants the lesions persisted at 1 year of age, while in the fourth they remained at age 12 years. The nodules were not associated with any other disease or abnormality. A review of the literature revealed only one Argentinean series comprising four cases, and two communications at international pediatric congresses by French and American authors who reported five and three cases, respectively. We describe four additional cases of precalcaneal congenital fibrolipomatous hamartoma and comment on their histopathologic and ultrastructural characteristics.

Precalcaneal congenital fibrolipomatous hamartoma: report of 2 cases

“…There may be increased number of blood vessels evenly distributed and with no associated perivascular alterations [6]. The size or number of nerve fibers is normal, and fibrous tissue is not increased [3].…”

“…The size or number of nerve fibers is normal, and fibrous tissue is not increased [3]. The diagnosis is made clinically: the lesions are usually symmetrical, asymptomatic, and with normal overlying skin; the location is typical and present at birth or appearing a few months latter [5][6][7]. Biopsies are rarely indicated [3].…”

Precalcaneal Congenital Fibrolipomatous Hamartomas: Report of 3 Additional Cases and Discussion of the Differential Diagnosis

“…Descriptions of long-term outcome are almost totally lacking, particularly as the condition had not been recognized until a few years ago. In one case series the lesions persisted 1 year after initial diagnosis in 3 children, while in a fourth they persisted and remained asymptomatic at 12 years of age [12]. Persistence of PCFH in a 20-year- and a 28-year-old person suggests that the malformation does not necessarily have to involute with age [10, 13].…”

A Male Infant with Bumps on His Feet

“…Literature review reveals that biopsy of these papules usually gives a benign picture with the presence of mature adipose tissue in the mid-and reticular dermis, surrounded by collagenous, nonhypertrophic, fi brous septa. 5 Infants with pedal papules grow normally with no delay in the developmental milestones, especially with standing and walking. The natural history of this condition is unknown; cases in the literature mainly focus on the fi rst years of infants' lives.…”