Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2022 Jun 7:9:917560.
doi: 10.3389/fsurg.2022.917560. eCollection 2022.

Case Report: Unusual Heterotopic Ossification of the Hindfoot

Falcioni Danya  1 , Baldini Marco  2 , Coppa Valentino  1 , Marinelli Mario  1 , Gigante Antonio Pompilio  2   1
Affiliations
Case Reports

Case Report: Unusual Heterotopic Ossification of the Hindfoot

Falcioni Danya et al. Front Surg. .

Abstract

Heterotopic ossification (HO) is a pathologic condition in which aberrant lamellar bone deposits in soft tissues, outside of the normal skeleton. Pathogenesis is still unclear, but different risk factors are known. Here we report a case of a 14 year-old girl presenting with pain in the medial calcaneal region and evidence of a rapidly growing, firm and solid neoformation. The lesion was diagnosed 6 years earlier, but it was consistently smaller and asymptomatic so that the patient did not undergo any follow up. The patient had no previous trauma or surgery, no other risk factors for HO and did not show any clinically evident HO in other districts. Xray and CT showed a heterogeneous bony lesion in the context of soft tissues, isolated from the calcaneus. After complete excision, histological analysis confirmed the diagnosis of HO. In conclusion, lone non congenital HO can occur regardless of known risk factors. Small HO lesion may also enter a proliferative phase without evidence of triggering events. More studies are required to better understand etiopathogenesis of HO in these clinical settings.

Keywords: bone; case report; children; foot; heterotopic ossification.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest..

Figures

Figure 1
Figure 1
(A) Old X-ray showing the clinically silent lesion at the age of 6 years. (B) Clinical picture showing the mass covered with areas of hyperkeratosis. (C) New X-ray at time of presentation showed increased size of the lesion. (D–F) Preoperative CT section of the lesion.
Figure 2
Figure 2
(A) Intraoperative image of the excision of the mass. (B) Picture of the sample measuring approximately 2.5 × 1.5 × 2 cm. (C) Section of the lesion as seen with optic microscopy and Hematoxylin & Eosin staining. The specimen shows “mixed fibrous-adipose dermo-epidermal tissue with foci of stromal osseous metaplasia”, as confirmed also by pathology report.
Figure 3
Figure 3
Xray 6 months after surgery confirming complete excision of the lesion without residual pathology.
Figure 4
Figure 4
Timetable reporting relevant data from the episode of care.
See this image and copyright information in PMC

References

    1. Meyers C, Lisiecki J, Miller S, Levin A, Fayad L, Ding C, et al. Heterotopic ossification: a comprehensive review. JBMR Plus. (2019) 3(4):e10172. 10.1002/jbm4.10172 - DOI - PMC - PubMed
    1. Teasell RW, Mehta S, Aubut JL, Ashe MC, Sequeira K, MacAluso S, et al. A systematic review of the therapeutic interventions for heterotopic ossification after spinal cord injury. Spinal Cord. (2010) 48(7):512–21. 10.1038/sc.2009.175 - DOI - PMC - PubMed
    1. Riegler HF, Harris CM. Heterotopic bone formation after total hip arthroplasty. - Cerca con Google. https://www.google.com/search?q=Riegler+HF%2C+Harris+CM.+Heterotopic+bon... (Accessed December 17, 2020). - PubMed
    1. Hong CC, Nashi N, Hey HW, Chee YH, Murphy D. Clinically relevant heterotopic ossification after elbow fracture surgery: a risk factors study. Orthop Traumatol Surg Res. (2015) 101(2):209–13. 10.1016/j.otsr.2014.10.021 - DOI - PubMed
    1. Licini C, Farinelli L, Cerqueni G, Hosein A, Marchi S, Gigante A, et al. Heterotopic ossification in a patient with diffuse idiopathic skeletal hyperostosis: input from histological findings. Eur J Histochem. (2020) 64(4):317–22. 10.4081/EJH.2020.3176 - DOI - PMC - PubMed

Publication types

LinkOut - more resources