Recalcitrant calcaneal intraosseous lipoma treated with a cadaveric femoral head allograft plug and internal fixation in a 22-year-old military veteran: A case report

Abstract

Introduction

Intraosseous lipomas (IOL's) are rare benign tumors of mature adipose tissue within the bone, most commonly found in the calcaneus, femur, tibia, and humerus. These lesions are typically asymptomatic and often discovered incidentally in imaging studies. Calcaneal IOL's pose unique challenges due to their location and potential for significant structural compromise.

Body

Here we describe a young male with a recalcitrant calcaneal IOL's without remission of symptoms from previous treatments. Surgery consisted of aggressive lesion debridement with remodeling and interpositional packing of a cadaveric femoral head allograft and tibial autograft Additionally, the construct was secured with a lag screw and supported by an anatomic lateral wall plate. The patient at two years post-operation has returned to normal weight-bearing, comfortable ambulation, and increased quality of life working as a full-time mail carrier.

Conclusion

To the authors’ knowledge, this is the first report of an IOL's in the foot and ankle literature treated with a cadaveric femoral head allograft and internal fixation. Our approach underscores the efficacy of combining aggressive tumor resection with structural allografts and non-structural autografts protected with internal fixation, offering a promising alternative in managing benign calcaneal neoplasms refractory to conventional therapies.