PMC8287342_01
(a) Preoperative soft tissue mass on lateral region of right calcaneus. (b)
Preoperative lateral radiograph showing a lytic lesion on calcaneal
tuberosity without periosteal reaction. No acute fracture was noted.
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Radiographs showed a calcaneal tuberosity osteolytic lesion with marginal sclerosis and no associated periosteal reaction (Figure 1).
Sagittal (a) and axial (b) T2-weighted MRI showing a 3.2 cm x 3.0 cm x 2.8 cm
infiltrative hyperintense lesion with geographic margins. Erosion of the
posterolateral cortex and significant local edema. (c). Sagittal T1-weighted
MRI.
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Posterolateral cortex erosion and significant bone and soft tissue edema were also observed (Figure 2).
(a) Gross specimens showing a soft, gray, mucoid, and gelatinous mass
associated with purulent secretion. (b) Cavitary defect after complete
resection of the lesion.
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Soft tissue found inside the cavitary was a soft, gray, mucoid, and gelatinous mass associated with purulent secretion (Figure 3).
(a) The histologic specimens showed the appearance of Cryptococcus
neoformans into the cytoplasm of macrophages (arrow),
hematoxylin and eosin staining (a) (x400), and periodic acid-Schiff (PAS)
staining (inset) (x400) (b).
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Cryptococcus neoformans was histologically found as spherical or yeast-like organisms within the cytoplasm of macrophages, and no granulomas were seen (Figure 4).
(a) Clinical image showing complete healed lesion. (b) Postoperative lateral
radiograph at 1-year follow-up.
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The pain had progressively reduced at 2-year follow-up, and the patient was completely recovered and walking normally (Figure 5).
Sagittal (a) and axial (b) T2-weighted MRI showing a slight reduction of the
hyperintense lesion.
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MRI showed a slight decrease in the lesion size (Figure 6).