Multiply Recurrent Calcaneal Osteochondroma: A Case Report

Osteochondromas are the most common benign bone tumors, typically presenting as cartilage-capped bony projections on the external surface of bones. Recurrent isolated osteochondromas are uncommon and have a low recurrence rate after surgical resection. Previous literature has documented solitary osteochondromas in the calcaneus, but to our knowledge, recurrent cases have not been reported.

A 20-year-old female presents after the removal of a calcaneal osteochondroma by podiatry at the age of 12 and again at the age of 17. The lesion recurred again at age 18, and the patient was then referred to orthopedic oncology. The patient’s primary presenting symptom was a slowly enlarging bump on her heel. The lesion was again excised, and the pathology was consistent with osteochondroma. She had no recurrence until 23 months postoperatively. At that point, she presented again with a bump slowly increasing in size as well as pain after several months of significantly increased walking while abroad. The lesion was again removed with care taken to remove all satellite lesions and to bur the main lesion down to normal calcaneus. The patient has had no recurrence at the most recent follow-up of 6 months.

This case report highlights the unusual presentation of a multiply recurrent calcaneal osteochondroma, emphasizing the need for comprehensive surgical excision and diligent follow-up. Incomplete resection is the most common reason for recurrence. However, given the lesion's location, this case raises the question of whether repetitive stress from increased walking may have contributed to its recurrence.