Dedifferentiated Low Grade Chondrosarcoma Of Calcaneum, A Rare Tumor: A Case Report

Abstract

INTRODUCTION
Tumors of calcaneum are very rare. Due to lack of awareness about the calcaneum tumors among the general physicians, there is always either delay in diagnosis or misdiagnosis and therefore there is dilemma in offering correct treatment. Here we are presenting a rare case of dedifferentiated mild grade chondrosarcoma of right calcaneum, which was initially diagnosed on FNAC as Chondromyxoid Fibroma.
CASE REPORT
A 71-year-old man referred to OPD by local practitioner, for right heel pain on and off and swelling for two year which was not responding to the treatment. Swelling around the heel was gradually progressing. X ray of right foot and ankle showing soap bubble appearance in the calcaneum and cortex was intact. Patient underwent FNAC and the report was suggestive of chondromyxoid fibroma a rare benign tumor. Hence patient underwent excision, curettage and bone grafting procedure. The material sent for re- confirmation and the report was confirmed as dedifferentiated type of low-grade chondrosarcoma, a low-profile malignant tumor. Below knee amputation was carried out. Patient now, six-month post-surgery and walking on ‘Jaipur foot’ type of prosthesis with no relapse till date.
CONCLUSION
Tumor of calcaneum is very rare, hence detail clinico-pathological-radiological evaluation is very much essential to avoid misdiagnosis and delay in treatment. Chronic heel pain and swelling around heel are misdiagnosed as chronic benign conditions like ankle ligament sprain or retrocalcaneal bursitis, plantar fasciitis, infection or old malunited fracture calcaneum. Any tumor of calcaneum which is rare should be reported and multidisciplinary evaluation to be carried out along with limited open biopsy (Gold standard), to confirm the histological diagnosis.