Intraosseous lipoma of the calcaneus: a rare radiological finding. A case report

Objective: Intraosseus lipomas are an uncommon pathological entity. Its prevalence, however, is believed to be underestimated. We present a clinical case seen in a medical center consultation. Clinical case: We report the case of a 57-year-old man without noteworthy pathological or family history, who consults at his health center due to periodic mild mechanical right heel pain during the past year. Results: A simple imaging study of the affected foot was requested, which revealed a well-defined osteolytic lesion with a thin, linear sclerotic margin and a central calcification, without cortical disruption or involvement of adjacent soft tissues, exhibiting a nonaggressive radiological appearance. This image is referred to as a "bull's eye" or "cokade" and is suggestive of an intraosseous lipoma. The diagnosis was confirmed with the performance of magnetic resonance imaging. Conclusion: The nonaggressive characteristics of this disease guides towards conservative management of intraosseus lipoma, reserving invasive surgical options only in case of complications or increased fracture risk.