Precalcaneal congenital fibrolipomatous hamartoma

The patients are four unrelated children, one boy and three girls, aged between 3 and 7 months. All the patients were born at term, had normal postnatal development, and were in good general health. Each child presented from birth with a single plantar nodule, between 0.5 and 1.5 cm in diameter, bilaterally and symmetrically localized on the medial side of the plantar surface of both heels (Fig..1). The nodules were skin-colored, covered by normal epidermis, unattached to the underlying tissues, of soft and elastic consistency, nonpulsatile, and nontender to touch. They did not transilluminate. The patients' familial histories were negative for similar disorders. Three of the patients underwent cutaneous ultrasound and echo-color-Doppler which confirmed the presence of a dermal mass and ruled out its cystic or vascular nature. The fourth patient was lost at follow-up. Three of the four children were referred to orthopedics for checking at 1.year. The nodules did not cause abnormal gait development, and functional impairment was excluded; however, orthopedic follow-up was advised. One patient had X-ray examination of the feet, which yielded negative results. The lesions persisted unchanged or grew proportionately with the children's growth throughout the follow-up period. Follow-up varied from zero to 3 years. Skin biopsies were felt to be unnecessary. No surgical excisions were performed in any of the patients.