• Sung Hun Won, Jahyung Kim, Jaeho Cho, Dong-Il Chun, Kwonwoo Kim, and Young Yi.
• Department of Orthopaedic Surgery, Bone & Joint center, Soonchunhyang University Seoul Hospital, Seoul, Republic of Korea.
• Medicine (Baltimore). 2021 Jul 30; 100 (30): e26803e26803.

RationaleCalcifying aponeurotic fibroma (CAF) is a rare benign fibroblastic tumor that is commonly in the hand or foot of children or adolescents.Patient ConcernsA 74-year-old female presented with a progressive pain on the medial foot for 3 years ago. The pain aggravated while walking or in a standing position for more than 20 minutes. She also complained of skin contact along the medial aspect of the foot while trying to wear a shoe.DiagnosisPhysical examination revealed a firm, immobile, nontender mass accompanied with flexible flatfoot. On the single heel raise test, loss of the balance and intensification of the pain were observed. Faintly calcified soft tissue mass is shown in plain radiographs without bone involvement. Magnetic resonance imaging revealed a subcutaneous mass with ill-defined circumscribed subcutaneous mass adherent to the thickened PTT.InterventionsThe patient underwent a complete excisional biopsy, followed by medial displacement calcaneal osteotomy.OutcomesThe excised mass was diagnosed to be CAF on the histologic examination. At the 1-year follow-up, patient remained asymptomatic with no evidence of recurrence and all the radiographic parameters demonstrating flat foot improved.LessonsThis is the first case of CAF located at PTT presenting with both foot pain and functional disability. In this case, complete excision of the causative structure along with alignment correction can contribute to successful postoperative outcome.Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.

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