Plantar Nerve Neural Fibro-Lipoma – Rare Neuroma Arising from the Plantar Nerve of the Heel

Raghav N and Dakshinamurthy S

Department of Trauma and Orthopedics, Scunthorpe General Hospital, UK
Department of Foot and Ankle, Scunthorpe General Hospital, UK

^*Correspondance to: Raghav Nand 

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Abstract:

Every year, as many as 2 million patients worldwide present with plantar heel pain with men and women affected equally. This case reports reflects upon a healthy 46 year old female who presented with subtype of true neoplasm called a neural fibrolipoma arising from the plantar nerve. The patient was referred by her GP for an evaluation of an unknown painful soft tissue mass present in the right plantar aspect of the mid foot. The mass had been present for approximately 2 to 3 years and had recently increased in size in the last 4 months. This 17 mm × 7 mm × 11 mm painful soft tissue swelling was detected by USS and showed it extended deep to the plantar fascia not arising from it hence ruling out the common misconception of plantar fibromatosis. When reviewing such patients, it is imperative to rule out any malignancy before excising the mass which is why referring this patient to a Sarcoma MDT was essential. Other infectious differentials including septic arthritis and osteomyelitis were ruled out early since Blood counts showed CRP – 1.2 mg/L, White cell count – 5.1 × 109/L, Neutrophils – 3.47 × 109/L. Arthritic differentials such as Gout were also ruled out based on blood parameters which revealed Urate – 287. The patient opted for surgical excision biopsy of the lesion. Post operative period was uneventful with good healing of the wound She was followed up 2 months and at with the histology findings results revealed a rare soft tissue neural neoplasm in keeping of a neurofibrolipoma. The patient was happy with the overall outcome and discharged. This case report highlights the need to consider the neural fibrolipoma as a rare case of plantar/heel pain and excision of the lesion would provide an excellent outcome.

Keywords:

Plantar nerve; Neural fibrolipoma; Neuroma

Cite the Article:

Raghav N, Dakshinamurthy S. Plantar Nerve Neural Fibro-Lipoma – Rare Neuroma Arising from the Plantar Nerve of the Heel. Clin Case Rep Int. 2022; 6: 1352.